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新型冠状病毒肺炎感染所致的非创伤性脾破裂

Atraumatic splenic rupture due to covid-19 infection.

作者信息

Shaukat Irfan, Khan Raisa, Diwakar Lavanya, Kemp Timothy, Bodasing Neena

机构信息

Infectious Disease Unit, University Hospital of North Midlands, United Kingdom of Great Britain and Northern Ireland.

Immunology, University Hospital of North Midlands, United Kingdom of Great Britain and Northern Ireland.

出版信息

Clin Infect Pract. 2021 Apr;10:100042. doi: 10.1016/j.clinpr.2020.100042. Epub 2020 Sep 25.

Abstract

BACKGROUND

Covid-19 is a novel disease caused by the severe acute respiratory coronavirus (SARS-CoV2). We discuss a gentleman who presented with an atraumatic rupture of the spleen secondary to this infection.

BRIEF SUMMARY OF PRESENTATION

A 57-year-old service engineer was brought into the emergency department after having collapsed at home. RT-PCR was positive for covid-19 infection. CT scan showed evidence of haemoperitoneum and splenic rupture. He underwent splenic artery embolisation and required ventilatory and circulatory support on ITU. He made a full recovery and was discharged home 3 weeks later.

DISCUSSION AND RELEVANCE

Atraumatic splenic rupture is a rare, potentially fatal condition which has been described as a complication of haematological and non-haematological malignancies, inflammatory disorders and infections. There is emerging evidence to suggest that covid-19 has a direct destructive impact on the spleen, causing lymphoid follicle attrition and nodular atrophy in addition to microvascular thrombosis and necrosis. This is the first report of atraumatic splenic rupture secondary to covid-19 infection, to our knowledge.

摘要

背景

新型冠状病毒肺炎(Covid-19)是由严重急性呼吸综合征冠状病毒2(SARS-CoV2)引起的一种新型疾病。我们讨论一位因该感染继发脾脏非创伤性破裂的男性患者。

病例简介

一名57岁的服务工程师在家中晕倒后被送往急诊科。新冠病毒19感染的逆转录聚合酶链反应(RT-PCR)呈阳性。计算机断层扫描(CT)显示有腹腔积血和脾脏破裂的迹象。他接受了脾动脉栓塞术,并在重症监护病房(ITU)需要通气和循环支持。他完全康复,3周后出院回家。

讨论及意义

非创伤性脾破裂是一种罕见的、可能致命的病症,已被描述为血液系统和非血液系统恶性肿瘤、炎症性疾病及感染的并发症。有新证据表明,新冠病毒19对脾脏有直接破坏作用,除了微血管血栓形成和坏死外,还会导致淋巴滤泡磨损和结节性萎缩。据我们所知,这是首例关于新冠病毒19感染继发非创伤性脾破裂的报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e567/7516473/81bfaf4213fc/fx1.jpg

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