Rice Jason P, Sutter Christian M
Branch Medical Clinic, Marine Corps Air Station Miramar, 19871 Mitscher Way, San Diego, CA 92145, USA.
J Med Case Rep. 2010 Nov 5;4:353. doi: 10.1186/1752-1947-4-353.
Atraumatic splenic rupture is a rare event that has been associated with several infectious disease processes. In the active duty military population, potential exposure to these pathogens is significant. Here we discuss the case of an active duty Marine with spontaneous splenic rupture upon return from a six-month deployment in Iraq.
A previously healthy 30-year-old Caucasian male active duty Marine presented with abdominal pain, fever and diarrhea after deployment to Iraq in support of Operation Iraqi Freedom. Based on clinical and radiographic evidence, a diagnosis of spontaneous splenic rupture was ultimately suspected. After exploratory laparotomy with confirmation of rupture, splenectomy was performed, and the patient made a full, uneventful recovery. Histopathologic examination revealed mild splenomegaly with a ruptured capsule of undetermined cause.
Spontaneous splenic rupture is a rare event that may lead to life-threatening hemorrhage if not diagnosed and treated quickly. Although the cause of this patient's case was unknown, atraumatic splenic rupture has been associated with a variety of infectious diseases and demonstrates some risks the active duty military population may face while on deployment. Having an awareness of these pathogens and their role in splenic rupture, clinicians caring for military personnel must be prepared to recognize and treat this potentially fatal complication.
非创伤性脾破裂是一种罕见事件，与多种传染病过程相关。在现役军人中，接触这些病原体的可能性很大。在此，我们讨论一例现役海军陆战队队员的病例，该队员在从伊拉克为期六个月的部署返回后出现自发性脾破裂。
一名此前健康的30岁白种人男性现役海军陆战队队员在被部署到伊拉克支持伊拉克自由行动后，出现腹痛、发热和腹泻症状。基于临床和影像学证据，最终怀疑为自发性脾破裂。在经剖腹探查确认破裂后，进行了脾切除术，患者完全康复，过程顺利。组织病理学检查显示脾脏轻度肿大，包膜破裂，原因不明。
自发性脾破裂是一种罕见事件，如果不迅速诊断和治疗，可能导致危及生命的出血。尽管该患者病例的病因不明，但非创伤性脾破裂与多种传染病相关，表明现役军人在部署期间可能面临一些风险。鉴于了解这些病原体及其在脾破裂中的作用，照顾军事人员的临床医生必须准备好识别和治疗这种潜在的致命并发症。
