International journal of surgery case reports · 2021
Atraumatic splenic rupture and infection-related glomerulonephritis in a patient with infected aortic aneurysm: A case report.
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Kiriyama Shunya, Imai Hisashi, Matsuhashi Nobuhisa, Murase Katsutoshi, Yoshida Kazuhiro, Suzui Natsuko
Аннотация
INTRODUCTION: Atraumatic splenic rupture is very rare and the case is often difficult to determine. We report a case of atraumatic splenic rupture in a patient with an infected aortic aneurysm.
CASE PRESENTATION: A 40-year-old man under evaluation and treatment for renal dysfunction presented with the sudden onset of epigastric pain. The patient had a previous history of aortic arch replacement for Stanford type B aortic dissection. Contrast-enhanced computed tomography revealed intraabdominal hemorrhaging around the spleen and intrasplenic extravasation of contrast medium, and atraumatic splenic rupture was diagnosed. The patient slipped into hemorrhagic shock, and emergency splenectomy was scheduled. The histopathological diagnosis was splenic rupture with splenic infarction. The patient became febrile on postoperative day 10. Repeat contrast-enhanced computed tomography revealed enlargement of a cystic aortic aneurysm that was present prior to splenectomy. Infected aortic aneurysm was suspected, which was confirmed following thoracic endovascular aortic repair performed on postoperative day 12.
DISCUSSION: We consider that splenic rupture occurred following infected of the kidney and spleen by an infected aortic aneurysm.
CONCLUSION: Infection should be considered as a cause in patients with atraumatic splenic rupture.
CASE PRESENTATION: A 40-year-old man under evaluation and treatment for renal dysfunction presented with the sudden onset of epigastric pain. The patient had a previous history of aortic arch replacement for Stanford type B aortic dissection. Contrast-enhanced computed tomography revealed intraabdominal hemorrhaging around the spleen and intrasplenic extravasation of contrast medium, and atraumatic splenic rupture was diagnosed. The patient slipped into hemorrhagic shock, and emergency splenectomy was scheduled. The histopathological diagnosis was splenic rupture with splenic infarction. The patient became febrile on postoperative day 10. Repeat contrast-enhanced computed tomography revealed enlargement of a cystic aortic aneurysm that was present prior to splenectomy. Infected aortic aneurysm was suspected, which was confirmed following thoracic endovascular aortic repair performed on postoperative day 12.
DISCUSSION: We consider that splenic rupture occurred following infected of the kidney and spleen by an infected aortic aneurysm.
CONCLUSION: Infection should be considered as a cause in patients with atraumatic splenic rupture.