Gennai Andrea, Basili Giancarlo, Lorenzetti Luca, Crocetti Giuseppe, Filidei Mario, Orciuolo Enrico, Prosperi Valerio, Goletti Orlando
U.O. di Chirurgia Generale, Ospedale E Lotti, Pontedera, Pisa.
Chir Ital. 2008 Sep-Oct;60(5):739-44.
Spontaneous rupture of the spleen without a history of trauma is a rare clinical entity and represents a dramatic abdominal emergency. Most cases of spontaneous rupture occur in a diseased spleen (pathological spontaneous rupture). The authors present the case of a 20-year-old man who presented with pain in the left upper quadrant and clinical signs of haemorrhagic shock. The execution of focused assessment with sonography for trauma in the emergency room revealed the rupture of a pathological spleen with massive haemoperitoneum. The patient underwent emergency splenectomy. Histological examination of the spleen diagnosed infiltration of B cell lymphoma. Spontaneous rupture of the spleen must be considered in patients with acute abdominal pain and haemorrhagic shock. The role of focused assessment with sonography for trauma in the emergency room is discussed.
无创伤史的自发性脾破裂是一种罕见的临床病症，是一种严重的腹部急症。大多数自发性脾破裂病例发生在病变脾脏（病理性自发性破裂）。作者报告了一名20岁男性病例，该患者左上腹疼痛并伴有失血性休克的临床体征。在急诊室进行的创伤重点超声评估显示病理性脾脏破裂并伴有大量腹腔积血。患者接受了急诊脾切除术。脾脏组织学检查诊断为B细胞淋巴瘤浸润。对于有急性腹痛和失血性休克的患者，必须考虑自发性脾破裂。本文讨论了急诊室创伤重点超声评估的作用。
