Harries Rl, Gomez Kf
Nevill Hall Hospital, Abergavenny, Wales.
J Surg Case Rep. 2012 Jul 1;2012(7):11. doi: 10.1093/jscr/2012.7.11.
Thrombolysis is the gold standard of treatment for acute myocardial infarction (MI), however can be associated with haemorrhagic complications. To date, splenic rupture following thrombolysis has only been reported in those with an associated history of major trauma or splenomegaly. We report a case of a 47-year old female who developed splenic rupture following thrombolysis treatment with no history of trauma or splenomegaly. She received Tenecteplase therapy for an inferior MI, and six hours later she developed upper abdominal pain and hypotension. CT showed large haemoperitoneum with a large peri-splenic haematoma. She subsequently underwent a laparotomy and splenectomy. Patient remained well and was discharged home eight days postoperatively.
溶栓治疗是急性心肌梗死（MI）的金标准治疗方法，但可能会伴有出血并发症。迄今为止，溶栓后脾破裂仅在有重大创伤或脾肿大相关病史的患者中报道过。我们报告一例47岁女性，在没有创伤或脾肿大病史的情况下，溶栓治疗后发生脾破裂。她因下壁心肌梗死接受了替奈普酶治疗，6小时后出现上腹部疼痛和低血压。CT显示大量腹腔积血和巨大的脾周血肿。随后她接受了剖腹手术和脾切除术。患者术后恢复良好，术后8天出院。
