Kular Saminderjit, Hoare Tim, Nice Colin
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
BJR Case Rep. 2016 Nov 7;3(2):20160100. doi: 10.1259/bjrcr.20160100. eCollection 2017.
We present the case of a 26-year-old male who was referred to the Emergency department with frank haemoptysis, fever and abdominal pain. He had suffered from an acute splenic rupture secondary to blunt abdominal trauma 3 weeks previously, when he was treated with transfemoral embolisation therapy. On this previous admission his splenic injury was initially not detected owing to CT scanning technique focussed on imaging the thorax rather than the abdomen. On readmission, the initial chest X-ray pointed towards a likely pneumonia or empyema. However, upon CT scanning, the cause was found to be a splenic abscess that had extended through the diaphragm, pleura and entered the bronchial space, forming a 'splenobronchial' fistula. This is a rare complication of splenic artery embolisation. The aim of this case report is to raise awareness of the complications that acute trauma and embolisation therapy may cause.
我们报告了一例26岁男性病例,该患者因明显咯血、发热和腹痛被转诊至急诊科。3周前,他因钝性腹部创伤继发急性脾破裂,当时接受了经股动脉栓塞治疗。在之前的这次入院时,由于CT扫描技术侧重于胸部成像而非腹部,他的脾损伤最初未被发现。再次入院时,最初的胸部X光片显示可能患有肺炎或脓胸。然而,CT扫描发现病因是脾脓肿已穿过膈肌、胸膜并进入支气管间隙,形成了“脾支气管”瘘。这是脾动脉栓塞的一种罕见并发症。本病例报告的目的是提高对急性创伤和栓塞治疗可能引起的并发症的认识。