Socolov D, Pantazescu A, Socolov R, Carauleanu A, Ilea C, Anghelache Lupascu I, Gologan E
Clin Exp Obstet Gynecol. 2016;43(4):619-620.
The authors present the case of a postpartum splenic rupture induced probably by iatrogenic injury (recent vaginal delivery with a prolonged expulsion with uterine fundus compression) including the left hypochondria region costal grid. The case was solved with splenic preservation and achieving hemostasis only by local plugging and Gelaspon. The case raised also other problems regarding the etiology of splenic rupture, in establishing a causal relationship between a intrapartum splenic injury, and the three episodes of inferior genital tract hemorrhaging, in establishing the cause of the infectious syndrome from the 24h postpartum day, (parietal infection or splenic abscess requiring splenectomy).
作者介绍了一例可能由医源性损伤（近期经阴道分娩，在子宫底按压下长时间娩出，包括左季肋区肋格栅）导致的产后脾破裂病例。该病例通过保留脾脏、仅采用局部封堵和明胶海绵实现止血得以解决。该病例还引发了关于脾破裂病因的其他问题，即在确定产时脾损伤与下生殖道三次出血发作之间的因果关系方面，以及在确定产后24小时起感染综合征的病因方面（壁层感染或脾脓肿需要行脾切除术）。
