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Journal of the Korean Society of Traumatology 2011;24(1):52-55.
Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis
Kyung Woon Jeung, Byung Kook Lee, Hyun Ho Ryu
Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea. bbukkuk@hanmail.net
간경화증 환자에서 경도 외상 후 발생한 지연 비장 파열
정경운∙이병국∙류현호
전남대학교 의과대학 응급의학교실
Abstract
The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.
Key Words: Splenic rupture; Abdominal injury; Hemoperitoneum
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