Non-Traumatic Splenic Rupture After Open Surgery for Type A Aortic Dissection: A Case Report and Literature Review

Aortic dissection is a severe condition that involves a tear in the wall of the major artery carrying blood out of the heart (aorta). This cardiac disease has a high mortality, particularly Stanford type A, which involves the first part of the aorta. Aortic dissection is characterized by urgent onset, rapid progress, and poor outcome [Nienaber 2003; Mehta 2002]. Surgery is the most effective treatment. Although there have been remarkable recent advances in the understanding and management of various aspects of these complex surgeries, many potential complications remain. Non-traumatic splenic rupture is a rare postoperative complication of type A aortic dissection, and there are only a few published reports discussing this complication. Splenic rupture is a life-threatening cause of intraperitoneal bleeding and often is associated with the preexisting pathology of the spleen in the absence of trauma [Renzulli 2009]. Its manifestation is characterized by abdominal pain, left shoulder pain, and even shock. Because of the history of aortic dissection, physicians initially may suspect arterial rupture. In our report, we aim to present the possibility of splenic rupture as a complication of aortic dissection surgery and the need for immediate surgical intervention.