Journal of Acute Care Surgery

Infection/Sepsis, Organ(liver, bowel, kideny etc.)

Nontraumatic Splenic Rupture due to Infectious Mononucleosis: Elliot A. Frank, James R LaFleur, Stanley Okosun; J Acute Care Surg 2019;9(2):69-71. Published online October 30, 2019; DOI: https://doi.org/10.17479/jacs.2019.9.2.69

Abstract
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A 19-year-old otherwise healthy male presented to the Emergency Department with left upper quadrant abdominal pain having felt a “pop” in his abdomen which was followed by nausea and lightheadedness. There was no evidence of trauma but 3 weeks earlier he began with symptoms of a sore throat and nasal congestion without cough. On subsequent investigation, given the patient’s acute abdominal pain, abnormal vitals and a non-diagnostic computed tomography scan, an emergent exploratory laparotomy was performed. There was 600 mL of blood evacuated from the abdomen. A 643-gram inflamed and ruptured spleen was identified and removed, and follow-up lab work was positive for heterophile antibody. This report describes spontaneous splenic rupture caused by infectious mononucleosis and compares characteristics of traumatic versus non-traumatic cases.

Citations

Citations to this article as recorded by

Splenic rupture or infarction associated with Epstein-Barr virus infectious mononucleosis: a systematic literature review
Johannes M. A. Toti, Beatrice Gatti, Isabella Hunjan, Lisa Kottanattu, Pietro B. Faré, Samuele Renzi, Mario G. Bianchetti, Gregorio P. Milani, Sebastiano A. G. Lava, Pietro Camozzi
Swiss Medical Weekly.2023; 153(5): 40081. CrossRef
Esplenectomía laparoscópica mano asistida en ruptura esplénica atraumática secundaria a mononucleosis: reporte de un caso
Lucía Sagüi-De la Fuente, Ana Fernanda Álvarez-Barragán, Guadalupe Javier Palacios-Saucedo, José Javier García-Salas, Guillermo Daniel Almaraz-Celis
Revista Mexicana de Cirugía Endoscópica.2021; 22(2): 89. CrossRef

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Emergency surgery, Organ(liver, bowel, kideny etc.)

Spontaneous Splenic Rupture: Christopher Horn, Jason Keune; J Acute Care Surg 2016;6(2):73-75. Published online October 30, 2016; DOI: https://doi.org/10.17479/jacs.2016.6.2.73

Abstract
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We present the case of a 27-year-old female who presented in hypovolemic shock due to splenic rupture without apparent cause. The patient underwent an open splenectomy followed by an uneventful recovery. Post-operatively the patient could recall no trauma, and exams for viral and neoplastic etiologies were unrevealing. Spontaneous splenic rupture is a rare condition requiring a high index of suspicion, and patients should be managed with prompt splenectomy.

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Trauma,

Therapeutic Options in Patients with Traumatic Splenic Injury: Dong Yeon Kang, Ji Woong Yeom, Young Goun Jo, Yun Chul Park, Wu Seong Kang, Jung Chul Kim; J Acute Care Surg 2016;6(2):62-67. Published online October 30, 2016; DOI: https://doi.org/10.17479/jacs.2016.6.2.62

Abstract
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Purpose

Splenic injury management has shifted to non-surgical treatment to preserve the spleen because of the postoperative risks of overwhelming post-splenectomy infection. In this study, we analyzed risk factors of therapeutic options for splenic injury, using medical records of Chonnam National University Hospital.

Methods

We reviewed the medical records of 110 consecutive patients with traumatic splenic injuries admitted from January 2009 to December 2013. Demographic characteristics and therapeutic options such as conservative treatment, angiographic embolization and emergency operation and clinical parameters were analyzed in this study.

Results

Thirty-four patients were treated surgically and seventy-six were managed with non- surgical treatment. Multivariate logistic regression identified age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.009∼1.072; p=0.01), hematocrit (OR, 0.878; 95% CI, 0.806∼0.957; p=0.003), contrast extravasation (OR, 7.644; 95% CI, 2.248∼25.986; p=0.001), spleen grade (OR, 2.08; 95% CI, 1.128∼ 3.836; p=0.019) as significant risk factors of emergent splenectomy.

Conclusion

Age, hematocrit, contrast extravasation, spleen grade were significant risk factors for emergent splenectomy.