Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Department of Orthopedic Surgery, Walter Reed Army Medical Center, Bethesda, MD, USA.
Am Surg. 2023 Aug;89(8):3487-3489. doi: 10.1177/00031348231161697. Epub 2023 Mar 5.
Atraumatic splenic rupture (ASR) is a rare occurrence but an important clinical entity. Although trauma is the most common cause of splenic rupture, there is limited literature on ASR. This case report discusses a 59-year-old woman presenting with tension hydrothorax and ASR in the setting of non-small cell lung carcinoma requiring emergent chest tube insertion and emergent splenectomy. Her hospital course was complicated by pulmonary embolism and thrombosis of the inferior vena cava. The patient expired three months after her initial presentation. This patient's presentation represents only the second documented case of atraumatic splenic rupture secondary to metastatic lung carcinoma without pathological evidence of splenic metastasis. Atraumatic splenic rupture secondary to metastatic NSCLC is a rare occurrence; though failure to detect, it may be fatal. Pathologic ASR may be an occult presentation of lung malignancy and in the presence of confirmed NSCLC may portend a poor prognosis.
创伤性脾破裂（ASR）虽然罕见，但却是一种重要的临床病症。尽管创伤是脾破裂最常见的原因，但关于 ASR 的文献有限。本病例报告讨论了一位 59 岁女性，因非小细胞肺癌出现张力性血胸和 ASR，需要紧急插入胸腔引流管和紧急进行脾切除术。她的住院过程中还并发了肺栓塞和下腔静脉血栓形成。该患者在初次就诊后三个月去世。该患者的表现仅为第二例有记录的无脾转移病理证据的转移性肺癌继发的非创伤性脾破裂。继发于转移性非小细胞肺癌的非创伤性脾破裂较为罕见；虽然未能检测到，但可能致命。病理性 ASR 可能是肺癌隐匿性表现，在确诊为非小细胞肺癌的情况下，预示着预后不良。
