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Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature

INTRODUCTION: Lymphangioma is an abnormal proliferation of lymphatic vessels. Isolated splenic lymphangioma (SL) is rare; in the last 30 years only 22 cases were reported in the literature. Diagnosis is difficult by the absence of typical symptoms and signs. SL is often asymptomatic and occasionally...

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Autores principales: Evola, Giuseppe, Mazzone, Giovanni, Corsaro, Antonino, Brancato, Giovanna, Evola, Francesco Roberto, Basile, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522038/
https://www.ncbi.nlm.nih.gov/pubmed/32987290
http://dx.doi.org/10.1016/j.ijscr.2020.09.045
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author Evola, Giuseppe
Mazzone, Giovanni
Corsaro, Antonino
Brancato, Giovanna
Evola, Francesco Roberto
Basile, Guido
author_facet Evola, Giuseppe
Mazzone, Giovanni
Corsaro, Antonino
Brancato, Giovanna
Evola, Francesco Roberto
Basile, Guido
author_sort Evola, Giuseppe
collection PubMed
description INTRODUCTION: Lymphangioma is an abnormal proliferation of lymphatic vessels. Isolated splenic lymphangioma (SL) is rare; in the last 30 years only 22 cases were reported in the literature. Diagnosis is difficult by the absence of typical symptoms and signs. SL is often asymptomatic and occasionally detected through radiological exams or, after the onset of a life-threatening complication, at surgery or pathological examination. Surgery represents the treatment of choice. PRESENTATION OF CASE: A 22-year-old Caucasian male was admitted to the Emergency Department after a car accident, complaining of sudden onset, severe, left upper quadrant abdominal pain. Abdominal examination revealed mild abdominal distention and a severe abdominal pain on superficial and deep palpation of left upper abdominal quadrant with obvious muscle guarding and rebound tenderness. Abdominal computed tomography scan showed splenic rupture with hemoperitoneum. Laboratory tests reported severe anemia. The patient received blood transfusions and was taken emergently to the operating room for exploratory laparotomy, evacuation of hemoperitoneum and splenectomy. The postoperative course was uneventful, the patient was discharged on the 7th post-operative day. Diagnosis of microcystic SL was made at pathological examination. DISCUSSION: Post-traumatic splenic rupture may be favored by the presence of a unknown and asymptomatic isolated SL. Although different types of treatment of SL are reported in the literature, splenectomy represents the treatment of choice to avoid complications. CONCLUSION: Isolated SL is difficult to diagnose and suspect because of lack of pathognomonic symptoms and specific diagnostic signs. It can be diagnosed after the onset of a life-threatening complication. Splenectomy is the preferable definitive treatment.
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spelling pubmed-75220382020-10-02 Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature Evola, Giuseppe Mazzone, Giovanni Corsaro, Antonino Brancato, Giovanna Evola, Francesco Roberto Basile, Guido Int J Surg Case Rep Case Report INTRODUCTION: Lymphangioma is an abnormal proliferation of lymphatic vessels. Isolated splenic lymphangioma (SL) is rare; in the last 30 years only 22 cases were reported in the literature. Diagnosis is difficult by the absence of typical symptoms and signs. SL is often asymptomatic and occasionally detected through radiological exams or, after the onset of a life-threatening complication, at surgery or pathological examination. Surgery represents the treatment of choice. PRESENTATION OF CASE: A 22-year-old Caucasian male was admitted to the Emergency Department after a car accident, complaining of sudden onset, severe, left upper quadrant abdominal pain. Abdominal examination revealed mild abdominal distention and a severe abdominal pain on superficial and deep palpation of left upper abdominal quadrant with obvious muscle guarding and rebound tenderness. Abdominal computed tomography scan showed splenic rupture with hemoperitoneum. Laboratory tests reported severe anemia. The patient received blood transfusions and was taken emergently to the operating room for exploratory laparotomy, evacuation of hemoperitoneum and splenectomy. The postoperative course was uneventful, the patient was discharged on the 7th post-operative day. Diagnosis of microcystic SL was made at pathological examination. DISCUSSION: Post-traumatic splenic rupture may be favored by the presence of a unknown and asymptomatic isolated SL. Although different types of treatment of SL are reported in the literature, splenectomy represents the treatment of choice to avoid complications. CONCLUSION: Isolated SL is difficult to diagnose and suspect because of lack of pathognomonic symptoms and specific diagnostic signs. It can be diagnosed after the onset of a life-threatening complication. Splenectomy is the preferable definitive treatment. Elsevier 2020-09-10 /pmc/articles/PMC7522038/ /pubmed/32987290 http://dx.doi.org/10.1016/j.ijscr.2020.09.045 Text en © 2020 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Evola, Giuseppe
Mazzone, Giovanni
Corsaro, Antonino
Brancato, Giovanna
Evola, Francesco Roberto
Basile, Guido
Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature
title Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature
title_full Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature
title_fullStr Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature
title_full_unstemmed Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature
title_short Hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: A case report and review of the literature
title_sort hemorrhagic shock from post-traumatic rupture of microcystic splenic lymphangioma: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522038/
https://www.ncbi.nlm.nih.gov/pubmed/32987290
http://dx.doi.org/10.1016/j.ijscr.2020.09.045
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