Ten-Year Experience with Atraumatic Splenic Rupture in a Tertiary University Hospital

Authors : Akile Zengin, Mithat Mert Yurdakul, Yavuz Selim Angın, Murat Ulaş

Pages : 128-132

Doi:10.20515/otd.1592522

View : 27 | Download : 67

Publication Date : 2025-01-17

Article Type : Research Paper

Abstract :In this present study, we aim to share our clinical experience in patients with atraumatic splenic rupture (ASR). The records of all patients were reviewed from January 2015 to May 2024, retrospectively. We had 8 patients diagnosed with ASR. Of the patients 62.5% (n=5) were female. The median age was 52.5 (37-72) years. Three patients had a history of malignancy, two had hematologic disease, and three had autoimmune disease.Two patients had previously undergone abdominal surgery.Two patients had a history of oral anticoagulant use.The median onset of symptoms was 16 (1-168) hours. Splenomegaly was detected in three patients via computed tomography. In one patient, a distal pancreatectomy was performed in addition to splenectomy, while for another patient, distal pancreatectomy, gastric wedge resection, and packing were performed. The median operation time was 122.5 (60-210) min. The median hospital stay was 8.5 (1-41) days. Pathological results showed adenocarcinoma metastasis in one patient (due to endometrial cancer), and necrotising granulomatous inflammation in one patient (due to abdominal tuberculosis). Early postoperative complication was seen only one patient as pancreatic fistula. Mortality occurred in three patients. One patient died in the second postoperative hour from hypovolemic shock, another from sepsis, and the third from a subarachnoid hemorrhage. Despite its clinically vague presentation,the diagnosis of spontaneous splenic rupture should be considered in patients with no history of trauma but who present with hypovolemic shock,acute abdomen or abdominal pain of unknown etiology.
Keywords : akut karın, spontan dalak rüptürü, travmatik olmayan dalak hasarı, intraabdominal kanama