[Spontaneous splenic rupture in chronic pancreatitis].
A 50-year-old woman complained of upper abdominal pain for several weeks, getting worse and radiating towards the left shoulder in the 24 hours preceding her hospital admission. Plain X-ray film of the abdomen revealed plaque-like calcifications projecting onto the tail of the pancreas. Ultrasound imaging demonstrated splenic rupture with free intra-abdominal fluid. During an emergency laparotomy the spleen was removed. At first the postoperative course was uneventful. But epigastric pain recurred a few days after discharge. Serum amylase and lipase concentrations were elevated (280 U/l and 553 U/l, respectively). Endoscopic retrograde cholangiopancreatography revealed chronic pancreatitis with a 3 cm pseudocyst in the tail of the pancreas. A papillotomy was performed, after which the symptoms rapidly regressed and the pancreatic enzyme concentrations fell. This was thus a case of spontaneous splenic rupture associated with previously undiagnosed chronic pancreatitis with inflammatory papillary stenosis and pseudocyst in the pancreatic tail.
Welk
E
E
Chirurgische Klinik I, Stadtkrankenhaus Worms.
Stein
U
U
Bindewald
H
H
Glogowski
P
P
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014670:Ampulla of Vater / Q000601:surgery; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012422:Rupture, Spontaneous; D013156:Splenectomy; D013161:Splenic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery