Reyes-Jaimes Libertad, Camacho-Aguilera José Francisco
Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, México.
Rev Med Inst Mex Seguro Soc. 2023 Jul 31;61(4):523-531. doi: 10.5281/zenodo.8200591.
Spontaneous splenic rupture is often life threatening due to delay in diagnosis and treatment. Abdominal pain, Kehr's sign, nausea, bloating, altered consciousness, and intestinal obstruction may be present. In larger splenic lesions, signs of peritonitis and hypovolemic shock are present. Contrast-enhanced computed tomography is the election study. Diagnosis is confirmed by negative viral serology and normal spleen on gross and histopathologic inspection. The most frequent treatment in splenectomy.
A 30-year-old male with no medical history presented with generalized abdominal pain accompanied by Kehr's sign. He is diagnosed with ruptured spleen by contrast-enhanced computed tomography and successfully treated with splenectomy. He was discharged 6 days after surgery.
Spontaneous rupture of the spleen is uncommon, but with high morbidity and mortality. It must be a differential diagnosis in the face of abdominal and/or chest pain, and the corresponding imaging studies should be carried out if the patient's conditions allow it, or their search during an exploratory laparotomy.
自发性脾破裂常因诊断和治疗延迟而危及生命。可能出现腹痛、凯尔氏征、恶心、腹胀、意识改变和肠梗阻。在较大的脾脏病变中,会出现腹膜炎和低血容量性休克的体征。增强计算机断层扫描是首选检查。通过病毒血清学阴性以及大体和组织病理学检查脾脏正常来确诊。最常见的治疗方法是脾切除术。
一名30岁无病史男性出现全腹痛并伴有凯尔氏征。经增强计算机断层扫描诊断为脾破裂,并成功进行了脾切除术。术后6天出院。
脾脏自发性破裂并不常见,但发病率和死亡率高。面对腹痛和/或胸痛时必须进行鉴别诊断,若患者情况允许应进行相应的影像学检查,或在剖腹探查术中进行排查。