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Atraumatic splenic rupture secondary to appendicular perforation by cecal volvulus
Alejandro Menéndez-Moreno1, Mauricio Burneo-Esteves1, Rafael Orti-Rodríguez1
1Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Tenerife, España.
Cirugia Y Cirujanos
|February 16, 2019
Summary
Atraumatic splenic rupture is a rare but life-threatening emergency. This case highlights the importance of considering splenic rupture in patients presenting with shock and abdominal pain, even without a clear traumatic event.
Area of Science:
- Emergency Medicine
- Surgical Pathology
- Abdominal Imaging
Background:
- Atraumatic splenic rupture is a rare surgical emergency, often presenting without a clear history of trauma, making diagnosis challenging.
- Patients may experience prolonged abdominal and lumbar pain before presenting with shock.
- A history of bariatric surgery may be a relevant factor in some cases.
Observation:
- A 45-year-old woman presented to the emergency department with a 3-week history of abdominal and lumbar pain, and was in shock.
- Imaging studies indicated splenic rupture.
- Emergent surgery revealed atypical findings.
Findings:
- The patient underwent emergent surgery for splenic rupture.
- Post-operative evolution was favorable.
- A comprehensive review of literature, patient history, and surgical findings suggested a potential cause for this unusual presentation.
Implications:
- Despite its infrequent occurrence, atraumatic splenic rupture carries significant mortality.
- Clinicians in emergency settings should maintain a high index of suspicion for splenic rupture in patients presenting with shock.
- Early diagnosis and surgical intervention are crucial for favorable outcomes in atraumatic splenic rupture.
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