Splenic rupture in a newborn.
Traumatic rupture of the spleen in the newborn is a rare event and is seldom reported in the literature. It can occur to an abnormally enlarged spleen or to a normal spleen. In the latter, it usually is associated with difficult delivery. Previously, the majority of patients died probably because of delayed or missed diagnoses. The classic presentation is a triad of bleeding, abdominal distension, and hemoperitoneum. High index of suspicion and improvement in diagnostic tools like ultrasonography and computed tomography are important contributions in early diagnosis so that appropriate treatment can be implemented. Splenectomy is no longer the standard treatment because it increases the chance of postsplenectomy sepsis. Instead, treatment should aim for hemostasis and preservation of spleen. The authors present a case of traumatic rupture of spleen in a normal newborn with normal labor and delivery. The first symptom began at 16 hours of age and evolved to a full-blown classic picture. The baby was saved without splenectomy, and the recovery was smooth and uneventful. This is probably the first reported case of a patient treated without splenectomy in this locality. Discussion of the condition and review of the literature also are presented.
Hui
C M
CM
Departments of Paediatrics and Surgery, Tuen Mun Hospital, Hong Kong, China.
Tsui
K Y
KY
D001720:Birth Injuries / Q000150:complications; D002483:Cellulose, Oxidized / Q000627:therapeutic use; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D013154:Spleen / Q000293:injuries; D013161:Splenic Rupture / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D002483:Cellulose, Oxidized; D006490:Hemostatics; C013695:Surgicel