title: Spontaneous rupture of the spleen secondary to amyloidosis.
abstract: Spontaneous splenic rupture (SSR) is a rare condition. It may be an idiopathic event or may occur secondary to a pathological condition of the spleen. Systemic amyloidosis is characterized by the extracellular deposition of amyloid proteins in one or more organs. The spleen can be affected in 41% of patients. Amyloidosis and consequently, splenic rupture may occur as a complication of amyloid infiltration. We present the case of a 61-year-old male with abdominal pain and hypotension. There were peritoneal signs during physical examination and falling hematocrit was reported in the laboratory tests. The patient was suspected of having an aortic dissection. Thoraco-abdominal computed tomography (CT) angiogram was negative and ultrasonography revealed splenic rupture and free fluid in the abdominal cavity. The patient underwent laparotomy when found hemoperitoneum as a consequence of splenic rupture. The subsequent histopathological report of the spleen revealed amyloidosis. Thus, in patients with abdominal pain and hypotension, we should suspect the possibility of a spontaneous splenic rupture, even without trauma or infection history.
authors.affiliation: Department of Surgery, Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hesam
authors.initials: H
authors.lastname: Shobeiri
authors.forename: Majid
authors.initials: M
authors.lastname: Einakchi
authors.forename: Mahtab
authors.initials: M
authors.lastname: Khajeh
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Motie
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000686:Amyloidosis / Q000150:complications*; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D013156:Splenectomy; D013158:Splenic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D013161:Splenic Rupture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography