title: Splenic hemorrhage: a complication of tissue plasminogen activator treatment.
abstract: 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.
authors.affiliation: Department of Medicine, Victoria Hospital, University of Western Ontario, London.
authors.forename: P K
authors.initials: PK
authors.lastname: Cheung
authors.forename: J M
authors.initials: JM
authors.lastname: Arnold
authors.forename: T D
authors.initials: TD
authors.lastname: McLarty
mesh_terms: 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
chemical_list: D010959:Tissue Plasminogen Activator