[Spontaneous rupture of a splenic artery].
BACKGROUND
Hemoperitoneum due to spontaneous rupture of a visceral vessel may result from a variety of underlying pathologies. However, its idiopathic form does not show evidence of any predisposition.


METHODS
An abdominal CT scan for acute abdominal pain yielded the unexpected diagnosis of a ruptured splenic artery in a 21-year-old patient. Hemostasis was achieved by endovascular coiling of a segmental splenic artery lacking any evidence of pathological transformation. An extensive intraabdominal hematoma was evacuated in a consecutive laparoscopy which, furthermore, confirmed interventional success. Despite extensive diagnostic efforts, the cause of the bleeding remained undefined.


CONCLUSIONS
Spontaneous hemoperitoneum may occasionally be considered as a cause of acute abdomial pain and is diagnostically challenging. An interdisciplinary approach is desirable to meet the objective of modern organ-preserving therapy in splenic artery rupture.
Abteilung für Allgemein-, Viszeral- und Gefässchirurgie mit Department Kinderchirurgie des Klinikums Kempten-Oberallgäu, Kempten (Allgäu), Deutschland. jscheele@gmx.net
J
J
Scheele
S
S
Huttner
L
L
Stettinger
P
P
Sterk
D000006:Abdomen, Acute / Q000209:etiology*; D000792:Angiography; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D006465:Hemoperitoneum / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D013157:Splenic Artery; D014057:Tomography, X-Ray Computed; D055815:Young Adult