Lee NA, Jeong ES, Jang HS, Park YC, Kang JH, Kim JC, Jo YG. Antiphospholipid syndrome with renal and splenic infarction after blunt trauma: A case report. World J Clin Cases 2022; 10(26): 9404-9410 [PMID: 36159402 DOI: 10.12998/wjcc.v10.i26.9404]
Corresponding Author of This Article
Young-Goun Jo, MD, PhD, Assistant Professor, Surgeon, Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, 160 Baekseo-ro, Dong-gu, Gwangju 61469, South Korea. thinkjo@hanmail.net
Research Domain of This Article
Emergency Medicine
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 J Clin Cases. Sep 16, 2022; 10(26): 9404-9410 Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9404
Antiphospholipid syndrome with renal and splenic infarction after blunt trauma: A case report
Na-A Lee, Eui-Sung Jeong, Hyun-Seok Jang, Yun-Chul Park, Ji-Hyoun Kang, Jung-Chul Kim, Young-Goun Jo
Na-A Lee, Eui-Sung Jeong, Hyun-Seok Jang, Yun-Chul Park, Jung-Chul Kim, Young-Goun Jo, Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju 61469, South Korea
Ji-Hyoun Kang, Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Gwangju 61469, South Korea
Author contributions: Lee NA, Jeong ES reviewed the literature and contributed to manuscript drafting; Jang HS analyzed and interpreted the imaging findings; Kang JH analyzed and interpreted the rheumatologic findings; Park YC, Kim JH, Jo YG were responsible for important intellectual content; all authors have read and approve the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: None of the authors had conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Young-Goun Jo, MD, PhD, Assistant Professor, Surgeon, Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, 160 Baekseo-ro, Dong-gu, Gwangju 61469, South Korea. thinkjo@hanmail.net
Received: May 8, 2022 Peer-review started: May 8, 2022 First decision: May 30, 2022 Revised: June 12, 2022 Accepted: August 6, 2022 Article in press: August 6, 2022 Published online: September 16, 2022 Processing time: 111 Days and 18.5 Hours
Abstract
BACKGROUND
In trauma patients, bleeding is an immediate major concern. At the same time, there are few cases of acute vascular occlusion after blunt trauma, and it is unclear what assessment and diagnosis should be considered for these cases. Herein, we describe a patient diagnosed with antiphospholipid syndrome after a hypercoagulable workup for acute renal and splenic vascular occlusion due to blunt trauma.
CASE SUMMARY
A 20-year-old man was admitted to the emergency department with abdominal pain after hitting a tree while riding a sled 10 h ago. He had no medical history. Radiological investigations revealed occlusion of the left renal artery with global infarction of the left kidney and occlusion of branches of the splenic artery with infarction of the central portion of the spleen. Attempted revascularization of the left renal artery occlusion through percutaneous transluminal angioplasty failed due to difficulty in passing the wire through the total occlusion. Considering the presence of acute multivascular occlusions in a young man with low cardiovascular risk, additional laboratory tests were performed to evaluate hypercoagulability. The results suggested a high possibility of antiphospholipid syndrome. Treatment with a subcutaneous injection of enoxaparin was started and changed to oral warfarin after two weeks. The diagnosis was confirmed, and he continued to visit the rheumatology outpatient clinic while taking warfarin.
CONCLUSION
A hypercoagulable workup can be considered in trauma patients with acute multivascular occlusion, especially in young patients with low cardiovascular risk.
Core Tip: Acute vascular occlusion following blunt trauma has been reported in a few trauma patients. We describe a case diagnosed with antiphospholipid syndrome after a hypercoagulable workup for acute multivascular occlusion due to blunt trauma. In trauma patients with acute multivascular occlusion or a hypercoagulable state, especially in young patients with low cardiovascular risk, a hypercoagulable workup may help evaluate other risk factors.
