Hadary Amram, Dashkovsky Igor, Rapaport Arkady, Cozakov Juan C
Department of Surgery, Ziv Medical Center, Safed, Israel.
Isr Med Assoc J. 2008 Dec;10(12):889-91.
Non-traumatic rupture of the spleen is a rare condition. It can occur in a pathological spleen caused by any of a variety of diseases. For yet unknown reasons this condition may sometimes involve an apparently normal spleen as well.
To examine the incidence, symptoms, causes, therapy and prognosis of "spontaneous" splenic rupture.
We conducted a retrospective study of seven patients diagnosed with splenic rupture not related to any traumatic event, who had been treated in the surgical department of a community hospital within the last 19 years.
The male to female ratio was 5:2. In some patients, no background disease that could explain increased friability of splenic tissue could be identified. In some cases, where hemodynamic stability and absence of peritoneal signs afforded observation, splenectomy was delayed. In one case it was avoided altogether.
"Spontaneous" rupture of spleen should be suspected when abdominal symptomatology occurs against a background of an acute infectious disease, especially in young males, or a disease known to affect target organs of the reticular endothelial system. Preoperative use of imaging studies in hemodynamically stable patients can sometimes obviate surgery, or in cases of massive hemoperitoneum reduce intraoperative time.
非创伤性脾破裂是一种罕见病症。它可发生于由多种疾病中的任何一种所导致的病理性脾脏。由于尚不明确的原因，这种情况有时也可能累及外观正常的脾脏。
研究“自发性”脾破裂的发病率、症状、病因、治疗及预后。
我们对过去19年内在一家社区医院外科接受治疗的7例诊断为与任何创伤事件无关的脾破裂患者进行了回顾性研究。
男女比例为5:2。在一些患者中，无法确定可解释脾组织脆性增加的基础疾病。在某些血流动力学稳定且无腹膜征可供观察的病例中，脾切除术被推迟。在1例病例中，完全避免了脾切除术。
当在急性传染病背景下出现腹部症状时，尤其是在年轻男性或已知会影响网状内皮系统靶器官的疾病中，应怀疑“自发性”脾破裂。对于血流动力学稳定的患者，术前使用影像学检查有时可避免手术，或在大量腹腔积血的情况下减少手术时间。
