Spontaneous splenic rupture after a left-side thoracotomy: report of a case.
We herein describe the case of a 59-year-old man who experienced a spontaneous splenic rupture 12 h after undergoing a left-side thoracotomy for a wedge resection of an unknown pulmonary nodular tumor following a history of malignant melanoma. He demonstrated no special abdominal diseases or traumas, except an uneventful cholecystectomy 12 years previously. Preoperatively, he was not on anticoagulation, aspirin, or nonsteroidal anti-inflammatory medication, and all coagulation tests were inconspicuous. At 12 h after lung surgery the patient showed signs of progredient hypovolemic shock. After ultrasonography, which showed a moderate amount of free intra-abdominal liquid, the patient was urgently taken to the operation room. Bleeding resulted from a rupture of an encapsulated hematoma from the spleen. No signs of adhesion around the spleen or of an injury of the left diaphragm were observed. A pathological analysis of the spleen revealed a normal dimension and a normal histological structure without any evidence of a hematological or neoplastic disease. The patient was discharged on the 12th day after surgery. A review on the literature and the differential diagnosis of this unusual case is presented and discussed.
Klotz
Stefan
S
Department of Thoracic and Cardiovascular Surgery, Muenster University Hospital, Albert-Schweitzer-Strasse 33, 48129, Muenster, Germany.
Semik
Michael
M
Senninger
Norbert
N
Berendes
Elmar
E
Scheld
Hans H
HH
D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012422:Rupture, Spontaneous; D013161:Splenic Rupture / Q000175:diagnosis / Q000209:etiology*; D013908:Thoracotomy