Pilkey R M, Lawrence M D, Wolfsohn A L, Walley V M
Department of Laboratory Medicine, University of Ottawa Heart Institute, Ottawa Civic Hospital, Ont.
Can J Surg. 1994 Oct;37(5):428-9.
A very unusual cause of splenic rupture is described in a 73-year-old man with severe coronary artery disease. A transthoracic intra-aortic balloon pump (IABP) was inserted during coronary artery bypass grafting and was used for 3 days. However, his hypotension continued, and ischemic changes in his hand were thought to be due to the use of the pump. He died 7 days later of cardiac arrest. Autopsy revealed multiorgan failure associated with a preoperative myocardial infarct. Numerous systemic arterial atheroemboli, likely resulting from IABP-related aortic trauma and hypotension, had given rise to severe acute pancreatitis. The necrotizing process within the pancreatic tail had extended to the splenic hilum, eroding its capsule and causing splenic rupture and hemoperitoneum.
一名患有严重冠状动脉疾病的73岁男性患者，出现了一种非常罕见的脾破裂原因。在冠状动脉搭桥手术期间插入了经胸主动脉内球囊反搏泵（IABP），并使用了3天。然而，他的低血压持续存在，手部的缺血性改变被认为是使用该泵所致。7天后，他因心脏骤停死亡。尸检显示多器官功能衰竭与术前心肌梗死有关。大量系统性动脉粥样硬化栓子，可能是由IABP相关的主动脉创伤和低血压引起的，导致了严重的急性胰腺炎。胰尾的坏死过程延伸至脾门，侵蚀了脾包膜，导致脾破裂和腹腔积血。
