Hernani BL, Silva PC, Nishio RT, Mateus HC, Assef JC, De Campos T. Acute pancreatitis complicated with splenic rupture: A case report. World Journal of Gastrointestinal Surgery 2015; 7(9): 219-222 [PMID: 26425272 DOI: 10.4240/wjgs.v7.i9.219]
Corresponding Author of This Article
Bruno L Hernani, MD, Digestive Surgery Resident, Irmandade da Santa Casa de Misericórdia de São Paulo Hospital, Santa Casa School of Medicine, Rua Dr Cesário Mota Jr 112, São Paulo 01221-020, Brazil. drbrunohernani@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World Journal of Gastrointestinal Surgery. Sep 27, 2015; 7(9): 219-222 Published online Sep 27, 2015. doi: 10.4240/wjgs.v7.i9.219
Acute pancreatitis complicated with splenic rupture: A case report
Bruno L Hernani, Pedro C Silva, Ricardo T Nishio, Henrique C Mateus, José C Assef, Tercio De Campos
Bruno L Hernani, Pedro C Silva, Ricardo T Nishio, Irmandade da Santa Casa de Misericórdia de São Paulo Hospital, Santa Casa School of Medicine, São Paulo 01221-020, Brazil
Henrique C Mateus, José C Assef, Tercio De Campos, Department of Surgery, Emergency Unit, Irmandade da Santa Casa de São Paulo Hospital, Santa Casa School of Medicine, São Paulo 01221-020, Brazil
Author contributions: Assef JC and De Campos T conceived of and designed the study and critically revised the paper; Hernani BL, Silva PC and Nishio RT acquired the data; Mateus HC analyzed the data; Mateus HC, Assef JC and De Campos T contributed technical procedures; Hernani BL, Silva PC, Nishio RT and Mateus HC interpreted the data; Silva PC and Nishio RT contributed to manuscript preparation; Hernani BL wrote the manuscript.
Institutional review board statement: Approval was obtained from the local ethical committee for the publication of this report.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bruno L Hernani, MD, Digestive Surgery Resident, Irmandade da Santa Casa de Misericórdia de São Paulo Hospital, Santa Casa School of Medicine, Rua Dr Cesário Mota Jr 112, São Paulo 01221-020, Brazil. drbrunohernani@gmail.com
Telephone: +55-11-21767000 Fax: +55-11-21767000
Received: April 4, 2015 Peer-review started: April 12, 2015 First decision: May 13, 2015 Revised: June 16, 2015 Accepted: July 11, 2015 Article in press: July 14, 2015 Published online: September 27, 2015 Processing time: 178 Days and 5.6 Hours
Abstract
Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography (CT) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventy-two hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.
Core tip: This report describes a rare case of atraumatic splenic rupture that occurred in a 30-year-old male patient with acute pancreatitis and splenic vein thrombosis. A computed tomography angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient underwent a splenectomy followed by ultrasound-guided percutaneous drainage.
