title: Delayed rupture of the spleen and streptokinase therapy.
abstract: Delayed rupture of the spleen is a rare but serious complication of blunt abdominal trauma. A 47-year-old woman with a history of fractured pelvis from a motor vehicle accident 6 months earlier presented with evidence of a myocardial infarction. Subsequent streptokinase administration was complicated by splenic rupture, which was managed by evacuation of the clotted blood and splenectomy. The patient made a complete recovery. The risk of splenic rupture and bleeding complications resulting from thrombolytic therapy for myocardial infarction is discussed, as are the controversy over whether delayed splenic rupture is a true diagnosis, the mechanism of rupture and the clues to impending rupture.
authors.affiliation: Department of Surgery, Wellesley Hospital, University of Toronto, Ont.
authors.forename: R
authors.initials: R
authors.lastname: Nam
authors.forename: M M
authors.initials: MM
authors.lastname: Carr
authors.forename: C G
authors.initials: CG
authors.lastname: Jamieson
mesh_terms: D000007:Abdominal Injuries / Q000150:complications*; D000075202:Contraindications; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D012307:Risk Factors; D013161:Splenic Rupture / Q000139:chemically induced* / Q000209:etiology; D013300:Streptokinase / Q000009:adverse effects* / Q000627:therapeutic use; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000150:complications*
chemical_list: D013300:Streptokinase