Balanis T, Lamwers S, Sanner B
Medizinische Klinik, Agaplesion Bethesda Krankenhaus Wuppertal, Hainstraße 35, 42109, Wuppertal, Deutschland.
Internist (Berl). 2019 Sep;60(9):982-986. doi: 10.1007/s00108-019-0639-y.
Spontaneous splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 60-year-old man with acute pancreatitis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for 2 days. He was diagnosed with acute pancreatitis of alcoholic etiology. The patient was admitted to the hospital for two recurrent episodes in the last 4 months of acute pancreatitis of alcoholic etiology. Magnetic resonance imaging of the abdomen revealed a suspicious area of necrosis. Seventy-two hours after admission, the patient had significant improvement in symptoms and the inflammation markers rapidly decreased. However, he showed clinical worsening on the seventh day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was performed with resection of the pancreatic tail.
自发性脾破裂是急性胰腺炎的一种罕见并发症。本报告描述了一名60岁男性急性胰腺炎并发脾破裂的病例。该患者因上腹部疼痛2天被收入急诊科。他被诊断为酒精性病因的急性胰腺炎。该患者在过去4个月内因酒精性病因的急性胰腺炎两次复发入院。腹部磁共振成像显示有一个可疑的坏死区域。入院72小时后，患者症状明显改善，炎症指标迅速下降。然而，他在住院第七天临床症状恶化，腹胀加重，血红蛋白水平降低。CT血管造影显示腹腔内有大量游离液体，伴有巨大脾血肿。患者随后接受了剖腹手术，术中发现脾实质破裂导致腹腔积血。行脾切除术并切除胰尾。
