Atraumatic splenic rupture and ileal volvulus following cocaine abuse.
We present the case of a 38-year-old male with an atraumatic splenic rupture, hemoperitoneum, and ileal volvulus following acute cocaine intoxication. Computed tomography showed a "whirl sign", a subcapsular splenic hematoma with suspected peripheral laceration, and diffuse hemoperitoneum. At laparotomy, the spleen was confirmed to be the source of bleeding and was removed. A nonreducible volvulus was found at the distal ileum, and this segment of small bowel was removed. The patient had an uneventful postoperative recovery.
Department of Surgery, Louisiana State University Health-Shreveport, Louisiana.
David H
DH
Ballard
Department of Surgery, Louisiana State University Health-Shreveport, Louisiana.
J Patrick
JP
Smith
Department of Surgery, Louisiana State University Health-Shreveport, Louisiana. Electronic address: nsamra@lsuhsc.edu.
Navdeep S
NS
Samra
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications / Q000000981:diagnostic imaging*; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000601:surgery; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D007813:Laparotomy; D008297:Male; D013161:Splenic Rupture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Atraumatic splenic rupture; Cocaine toxicity; Cocaine-related splenic injury; Small bowel volvulus; Whirl sign