title: Atraumatic splenic rupture cases presenting with hemorrhagic shock and coagulopathy treated by splenic artery occlusion using a microballoon catheter before splenectomy.
abstract: Atraumatic splenic rupture (ASR) is an uncommon pathologic condition in which bleeding from the spleen occurs for a variety of nontraumatic reasons. While the current trend in traumatic splenic rupture is nonoperative management including transcatheter arterial embolization, the current recommendation for the treatment of most patients with ASR is splenectomy. In this report, we describe two cases of ASR presenting with hemorrhagic shock and complicated by anticoagulation therapy. In patients with severe hemorrhagic shock and coagulopathy, a damage control strategy is recommended. Our successful treatment of these patients included a three-step strategy as a damage control: (i) rapid transient hemostasis by splenic artery occlusion using a microballoon catheter, (ii) damage control resuscitation and (iii) splenectomy as a definitive hemostatic treatment.
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan yousuke.jpn4035@gmail.com.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsumoto
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Kurita
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hattori
authors.affiliation: Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Toma
authors.affiliation: R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA.
authors.forename: William Arthur
authors.initials: WA
authors.lastname: Teeter
authors.affiliation: Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Oda