title: Operative management of splenic injury in a patient with proteus syndrome.
abstract: A 20-year-old female with Proteus syndrome sustained splenic injury after fall from a bike. She was initially managed non-operatively at a different hospital for three days and was then referred to our level I trauma center in view of increasing abdominal pain and distention. On admission in the Emergency Department (ED), her pulse rate was 120 per minute and blood pressure was 108/68 mm Hg. Clinical examination showed a distended abdomen with left hypochondrial pain. Ultrasonogram (USG) and Computed Tomography (CT) of the abdomen showed splenomegaly and grade III splenic injury with significant hemoperitoneum. Her hemoglobin was 2.9 g/dl with packed cell volume (PCV) of 12%. In view of low hemoglobin and possibility of pathologic spleen, splenectomy was done. Microscopic examination of the spleen showed hemangiolymphangioma. The patient was discharged on the 5(th) post-operative day and is doing well at 6 months of follow-up.
authors.affiliation: Department of Surgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Umashankkar
authors.initials: U
authors.lastname: Kannan
authors.affiliation: Department of Surgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Biplab
authors.initials: B
authors.lastname: Mishra
authors.affiliation: Department of Surgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Arulselvi
authors.initials: A
authors.lastname: Subramanian
authors.affiliation: Department of Surgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sushma
authors.initials: S
authors.lastname: Sagar
authors.affiliation: Department of Surgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Surgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Maneesh
authors.initials: M
authors.lastname: Singhal
keywords: Proteus syndrome; hemangiolymphangioma; splenic injury
references.citation: Blood Coagul Fibrinolysis. 2007 Jul;18(5):505-8
references.pmid: 17581327
references.citation: An Pediatr (Barc). 2003 May;58(5):496-501
references.pmid: 12724087
references.citation: Zhonghua Xue Ye Xue Za Zhi. 2007 Mar;28(3):152-5
references.pmid: 17649705
references.citation: Am J Med Genet C Semin Med Genet. 2005 Aug 15;137C(1):38-52
references.pmid: 16010681
references.citation: J Comput Assist Tomogr. 2002 Mar-Apr;26(2):262-5
references.pmid: 11884784
references.citation: J Accid Emerg Med. 1997 Mar;14(2):111-3
references.pmid: 9132186
references.citation: Arch Surg. 1961 Nov;83:681-8
references.pmid: 14450201
references.citation: JAMA. 2001 May 2;285(17):2240-3
references.pmid: 11325326