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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
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A case of splenic rupture a week after appendectomy
Catherine Deleuze1, Celine Rasmont1, Todor Ivanov1
1General Surgery Department, Ambroise Paré Hospital, Mons, Belgium.
Journal of Surgical Case Reports
|December 15, 2021
Summary
A rare complication of appendicitis is spontaneous splenic rupture, a life-threatening condition. Prompt identification and treatment, including splenectomy, are crucial for patient survival.
Area of Science:
- Gastroenterology
- Surgical Complications
- Emergency Medicine
Background:
- Appendicitis with peritonitis can lead to severe intra-abdominal infections.
- Surgical management of perforated appendicitis involves appendectomy and peritoneal lavage.
- Postoperative complications require vigilant monitoring and timely intervention.
Observation:
- A 52-year-old woman experienced atraumatic splenic rupture one week after laparoscopic appendectomy for perforated appendicitis.
- Initial symptoms included hypotensive shock, abdominal pain, and pelvic drain bleeding.
- Computed tomography (CT) confirmed splenic rupture with significant hemoperitoneum.
Findings:
- Splenic artery embolization provided temporary relief, but the patient relapsed into shock.
- A subsequent splenectomy was performed.
- Pathological examination of the spleen revealed only inflammation, suggesting non-traumatic etiology.
Implications:
- Spontaneous splenic rupture is a rare but critical complication of appendicitis.
- Early diagnosis and immediate surgical or interventional treatment are essential.
- Bacteremia and subsequent splenitis, potentially linked to colonic microbiota, may precipitate splenic rupture.
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