Splenic hemorrhage: a complication of tissue plasminogen activator treatment.
Thrombolytic therapy with tissue plasminogen activator (tPA) for acute myocardial infarction may result in major bleeding complications such as gastrointestinal or intracranial bleeding. A case is described of severe splenic hemorrhage and rupture which developed 3 h after completion of tPA infusion for suspected acute myocardial infarction. The patient developed hypovolemic shock with abdominal pain and distension and further evidence of myocardial necrosis. A computed tomography scan of the abdomen was helpful in elucidating the diagnosis, and surgical splenectomy resulted in a good patient outcome, though the period of hypotension had increased the extent of myocardial necrosis.
Cheung
P K
PK
Department of Medicine, Victoria Hospital, University of Western Ontario, London.
Arnold
J M
JM
McLarty
T D
TD
D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D007022:Hypotension / Q000209:etiology; D009203:Myocardial Infarction / Q000188:drug therapy; D013161:Splenic Rupture / Q000139:chemically induced*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use
D010959:Tissue Plasminogen Activator