title: Ruptured splenic cavernous hemangioma in a neonate.
abstract: We present a case of a term neonate with hypovolemic shock after spontaneous vaginal delivery. Hemodynamic instability persisted despite resuscitation with packed red cells, fresh frozen plasma, and platelets. An ultrasound scan at 48 hours after birth followed by a computed tomographic scan demonstrated a splenic lesion and hemoperitoneum. She underwent an emergency laparotomy and splenectomy for splenic rupture. Histologic findings demonstrated a ruptured cavernous hemangioma of the spleen. Exsanguinating intraabdominal hemorrhage in the newborn infant is rare. The diagnosis and management, with particular reference to splenic cavernous hemangioma and splenic rupture, is discussed.
authors.affiliation: Pediatric Surgical Unit, Sheffield Children's Hospital, Sheffield, UK. pachl@doctors.org.uk
authors.forename: Max
authors.initials: M
authors.lastname: Pachl
authors.forename: Khalid
authors.initials: K
authors.lastname: Elmalik
authors.forename: Martha
authors.initials: M
authors.lastname: Cohen
authors.forename: Susan
authors.initials: S
authors.lastname: Kamupira
authors.forename: Jenny
authors.initials: J
authors.lastname: Walker
authors.forename: Govind
authors.initials: G
authors.lastname: Murthi
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D006465:Hemoperitoneum / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007231:Infant, Newborn; D007813:Laparotomy; D018570:Risk Assessment; D012769:Shock / Q000175:diagnosis / Q000209:etiology; D013156:Splenectomy / Q000379:methods; D013160:Splenic Neoplasms / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D013161:Splenic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D047929:Term Birth; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome