title: A case of spontaneous splenic rupture during chemotherapy for B-cell chronic lymphoid leukemia.
abstract: Spontaneous splenic rupture is a life-threatening disease and an important differential diagnosis of acute abdomen. Early clinical diagnosis and rapid intervention is required to ensure patient survival. Spontaneous splenic rupture may be induced by hematological, inflammatory or infiltrative diseases affecting the spleen. Splenomegaly may also significantly increase the risk of rupture. Other contributory factors include male, adulthood, rapid growth of the spleen and splenic abscess. Here, we present the case of a 69-year-old man who was undergoing chemotherapy for B-cell chronic lymphoid leukemia. He was admitted to our hospital after he suddenly developed persistent upper abdominal pain. Computed tomography and ultrasonography revealed accumulation of free fluid in and around the spleen. He was diagnosed as having spontaneous splenic rupture and an emergency operation was performed. During the operation, we found a massively enlarged spleen with several capsular tears, and performed a splenectomy. The patient made a good recovery. Pathological examination revealed that the spleen was infiltrated by CD20-, CD5- and CD23-positive lymphoid blasts. We encountered a case of spontaneous splenic rupture in a patient receiving chemotherapy for exacerbating B-cell chronic lymphoid leukemia. In a case of abdominal pain of acute onset in patients with hematological disease, spontaneous splenic rupture should be suspected.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sueyoshi
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan. yoshio@onh.go.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yoshio
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Suemura
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Araki
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Mitsuta
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Makiyo
authors.initials: M
authors.lastname: Ota
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Tatsumi
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Toyama
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Nakazuru
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kuzushita
authors.affiliation: Department of Surgery, Osaka National Hospital, Osaka, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsujie
authors.affiliation: Department of Surgery, Osaka National Hospital, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.affiliation: Department of Surgery, Osaka National Hospital, Osaka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.affiliation: Department of Pathology, Osaka National Hospital, Osaka, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka National Hospital, 2-1-14 Houenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
keywords: B-cell chronic lymphoid leukemia; Splenectomy; Spontaneous splenic rupture