[Spontaneous splenic rupture. Case report and literature review].

Libertad Reyes-Jaimes, José Francisco Camacho-Aguilera
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Abstract

Background: Spontaneous splenic rupture is often life threatening due to delay in diagnosis and treatment. Abdominal pain, Kehr's sign, nausea, bloating, altered consciousness, and intestinal obstruction may be present. In larger splenic lesions, signs of peritonitis and hypovolemic shock are present. Contrast-enhanced computed tomography is the election study. Diagnosis is confirmed by negative viral serology and normal spleen on gross and histopathologic inspection. The most frequent treatment in splenectomy.

Clinic case: A 30-year-old male with no medical history presented with generalized abdominal pain accompanied by Kehr's sign. He is diagnosed with ruptured spleen by contrast-enhanced computed tomography and successfully treated with splenectomy. He was discharged 6 days after surgery.

Conclusions: Spontaneous rupture of the spleen is uncommon, but with high morbidity and mortality. It must be a differential diagnosis in the face of abdominal and/or chest pain, and the corresponding imaging studies should be carried out if the patient's conditions allow it, or their search during an exploratory laparotomy.

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自发性脾破裂。病例报告及文献复习]。
背景:由于诊断和治疗的延误,自发性脾破裂常常危及生命。可能出现腹痛、克尔氏征、恶心、腹胀、意识改变和肠梗阻。脾损伤较大时,可出现腹膜炎和低血容量性休克的症状。对比增强计算机断层扫描是选举研究。病毒血清学阴性,脾脏大体和组织病理学检查正常,证实诊断。最常见的治疗方法是脾切除术。临床病例:30岁男性,无病史,以广泛性腹痛伴凯尔征就诊。他被诊断为脾破裂的对比增强计算机断层扫描和成功治疗脾切除术。术后6天出院。结论:自发性脾破裂并不常见,但有较高的发病率和死亡率。面对腹部和/或胸痛,必须进行鉴别诊断,如果患者条件允许,应进行相应的影像学检查,或在探查性剖腹探查时进行检查。
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