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Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy
Nontraumatic spontaneous splenic rupture (NSSR) has been encountered much more rarely compared with the traumatic splenic rupture. Although NSSR generally emerges in dialysis patients on account of such causes as the use of heparin during hemodialysis, uremic coagulopathy, infections, and secondary...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477390/ https://www.ncbi.nlm.nih.gov/pubmed/26157658 http://dx.doi.org/10.4103/2229-5151.158419 |
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author | Gazel, Eymen Açıkgöz, Gazel Kasap, Yusuf Yiğman, Metin Güneş, Zeki Ender |
author_facet | Gazel, Eymen Açıkgöz, Gazel Kasap, Yusuf Yiğman, Metin Güneş, Zeki Ender |
author_sort | Gazel, Eymen |
collection | PubMed |
description | Nontraumatic spontaneous splenic rupture (NSSR) has been encountered much more rarely compared with the traumatic splenic rupture. Although NSSR generally emerges in dialysis patients on account of such causes as the use of heparin during hemodialysis, uremic coagulopathy, infections, and secondary amyloidosis. Herein, we aimed to present a case of spontaneous splenic rupture which had developed soon after the inclusion of the case suffering from end-stage renal disease in routine hemodialysis program in the absence of any trauma or other prespecified risk factors for splenic rupture. A 55-year-old male patient was admitted to our hospital to have the ureteral double J stent removed. The operation was completed without any complication. Complaining an abdominal pain more prominent in the left upper abdominal quadrant in the first postoperative day, the patient underwent a through physical examination which disclosed abdominal distension, widespread tenderness, and rebound and defense positivity. The abdominal tomography depicted 122 × 114 × 95 mm lesion compatible with a hematoma. On the basis of these findings, an emergency exploratory operation was decided to be performed. Following clearance of the retroperitoneal hematoma, splenectomy was implemented. Experiencing progressive deterioration in his clinical status despite antibiotherapy, the patient unfortunately died of sepsis with multiorgan failure on the 25(th) postoperative day. In conclusion, NSSR is such an entity that may be missed out, can pursue variable clinical courses, and requires emergency therapy upon definitive diagnosis. The possibility of spontaneous bleedings should be kept in mind in any case with the history of hyperuricemia even in the absence of overt trauma, no matter if they are included in routine hemodialysis or not. |
format | Online Article Text |
id | pubmed-4477390 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-44773902015-07-08 Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy Gazel, Eymen Açıkgöz, Gazel Kasap, Yusuf Yiğman, Metin Güneş, Zeki Ender Int J Crit Illn Inj Sci Case Report Nontraumatic spontaneous splenic rupture (NSSR) has been encountered much more rarely compared with the traumatic splenic rupture. Although NSSR generally emerges in dialysis patients on account of such causes as the use of heparin during hemodialysis, uremic coagulopathy, infections, and secondary amyloidosis. Herein, we aimed to present a case of spontaneous splenic rupture which had developed soon after the inclusion of the case suffering from end-stage renal disease in routine hemodialysis program in the absence of any trauma or other prespecified risk factors for splenic rupture. A 55-year-old male patient was admitted to our hospital to have the ureteral double J stent removed. The operation was completed without any complication. Complaining an abdominal pain more prominent in the left upper abdominal quadrant in the first postoperative day, the patient underwent a through physical examination which disclosed abdominal distension, widespread tenderness, and rebound and defense positivity. The abdominal tomography depicted 122 × 114 × 95 mm lesion compatible with a hematoma. On the basis of these findings, an emergency exploratory operation was decided to be performed. Following clearance of the retroperitoneal hematoma, splenectomy was implemented. Experiencing progressive deterioration in his clinical status despite antibiotherapy, the patient unfortunately died of sepsis with multiorgan failure on the 25(th) postoperative day. In conclusion, NSSR is such an entity that may be missed out, can pursue variable clinical courses, and requires emergency therapy upon definitive diagnosis. The possibility of spontaneous bleedings should be kept in mind in any case with the history of hyperuricemia even in the absence of overt trauma, no matter if they are included in routine hemodialysis or not. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4477390/ /pubmed/26157658 http://dx.doi.org/10.4103/2229-5151.158419 Text en Copyright: © International Journal of Critical Illness and Injury Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Gazel, Eymen Açıkgöz, Gazel Kasap, Yusuf Yiğman, Metin Güneş, Zeki Ender Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
title | Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
title_full | Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
title_fullStr | Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
title_full_unstemmed | Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
title_short | Spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
title_sort | spontaneous splenic rupture due to uremic coagulopathy and mortal sepsis after splenectomy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477390/ https://www.ncbi.nlm.nih.gov/pubmed/26157658 http://dx.doi.org/10.4103/2229-5151.158419 |
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