title: Rupture of the spleen following thoracoscopic spine surgery in a patient with chronic pancreatitis.
abstract: OBJECTIVE
  To highlight the perioperative risk of intracapsular haematoma of the spleen or splenic ruptures during thoracoscopic spine surgery in patients with chronic pancreatitis.
  
  
  METHODS
  A 38-year-old patient with an L1 burst fracture (AO A3.3) underwent a standard thoracoscopic corpectomy and replacement of the vertebral body with an extendable vertebral body replacement 10 days after posterior instrumentation of T12-L2. In patients history chronic abusive alcoholism with related diseases such as pancreatitis, followed by hemipancreatectomy was found. Six hours after the surgery, the patient became hemodynamically unstable. An emergency CT scan revealed a splenic rupture. Emergent splenectomy was performed.
  
  
  RESULTS
  After surgical treatment of the L1 burst fracture, a rupture of the spleen was detected. An immediate splenectomy was performed. At the 18-month follow-up, an unchanged stable position of the cage was observed on CT.
  
  
  CONCLUSIONS
  Due to its proximity to the thoracolumbar junction, the spleen is vulnerable to injury during spine surgery. If the patient has undergone previous intra-abdominal operations or chronic inflammation of the pancreas is found, special care of the spleen during the operation is necessary.
authors.affiliation: Department of Traumatology and Sports Injuries, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020, Salzburg, Austria, r.bogner@salk.at.
authors.forename: Robert
authors.initials: R
authors.lastname: Bogner
authors.forename: Herbert
authors.initials: H
authors.lastname: Resch
authors.forename: Michael
authors.initials: M
authors.lastname: Mayer
authors.forename: Stefan
authors.initials: S
authors.lastname: Lederer
authors.forename: Reinhold
authors.initials: R
authors.lastname: Ortmaier
mesh_terms: D000328:Adult; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D050500:Pancreatitis, Chronic / Q000150:complications*; D012421:Rupture / Q000175:diagnosis / Q000209:etiology; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013154:Spleen / Q000293:injuries*; D013906:Thoracoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods