Spontaneous splenic rupture immediately after coronary bypass grafting.

A 54-year old man underwent coronary artery bypass graft for occlusion of three coronary arteries. There was no hematological abnormality detected preoperatively and the patient had normal coagulation tests and platelet count before the operation. During the first 24 hours after the operation, hemorrhagic drainage from the chest tubes was 700 ml ,and on postoperative day 1, he underwent reoperation. There was no further drainage from the chest tubes after re-operation but hematocrit level continued to fall. After having ruled out the thoracic source of bleeding, abdominal computed tomography was performed and confirmed intraperitoneal fluid accumulation and determined splenic rupture. The patient underwent emergent splenectomy and discharged from hospital on the sixth postoperative day with recovery.