title: How to manage splenic rupture during major liver resection?
abstract: Spontaneous splenic rupture is a rare but life threatening complication of major liver resection with only five reported cases during major liver resection under hepatic vascular occlusion. We report two cases of splenic rupture during liver resection including the first case during portal triad clamping. In both patients, the hemorrhage was stopped by removing the vascular clamp. A splenectomy was performed in both patients and liver resection was completed under vascular clamping without complications. Although very rare, physicians should be aware of the possibility of splenic rupture during liver resection because instead of increasing vascular occlusion, clamp removal usually stops the hemorrhage.
authors.affiliation: Assistance-Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Department of Surgery Boulogne.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ouaïssi
authors.forename: Stéphane
authors.initials: S
authors.lastname: Benoist
authors.forename: Christophe
authors.initials: C
authors.lastname: Penna
authors.forename: Bernard
authors.initials: B
authors.lastname: Nordlinger
mesh_terms: D000368:Aged; D003250:Constriction; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy; D008297:Male; D012422:Rupture, Spontaneous / Q000209:etiology / Q000601:surgery; D013156:Splenectomy; D013161:Splenic Rupture / Q000209:etiology / Q000601:surgery