A rare cause of intra-abdominal haemorrhage: spontaneous rupture of the splenic vein.
Spontaneous rupture of the splenic vein is rare, and is associated with high mortality. Few cases have been documented, associated with pregnancy, with hepatic cirrhosis and diseases predisposing to portal hypertension. We report a rare case with no evident symptoms or signs of liver deficiency, which was manifested with sudden massive intraperitoneal haemorrhage. An urgent laparotomy was performed and a tear of the splenic vein which was massively bleeding was found. The patient underwent urgent splenectomy and a biopsy of the liver was taken. The patient had an uneventful postoperative course. The histological examination documented the presence of micro-nodular liver cirrhosis. Rupture of the splenic vein is a rare condition, which should be considered in the differential diagnosis of intra-abdominal haemorrhage in a cirrhotic patient and in pregnant women. Control of haemorrhage and ligation of the splenic vein with urgent splenectomy is the appropriate treatment.
Safioleas
M C
MC
Department of Propedeutic Surgery, Athens University Medical School, Laiko Hospital, Athens, Greece.
Moulakakis
K G
KG
D000368:Aged; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D012422:Rupture, Spontaneous; D013156:Splenectomy; D013162:Splenic Vein / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery