Salame J, Mojddehian N, Kleiren P, Petein M, Lurquin P, Dediste A, Mendes da Costa P
Department of Surgery, Hôpital Français, U.L.B., Brussels.
Acta Chir Belg. 1993 Mar-Apr;93(2):49-53.
Atraumatic splenic ruptures in the course of infectious diseases are rare but have been reported. Various germs of viruses can be at the origin of such rupture. The more often quoted viral disease is infectious mononucleosis. The more frequently involved bacteria are Streptococcus non pneumoniae, Pseudomonas, staphylococci and Clostridium. Rupture mechanism is not clearly elucidated; it can be connected with sepsis diffusion at spleen level via haematogenic way and consequently splenomegaly. Splenic rupture following septicaemia does not always entail major splenomegaly nor abscess formation but the attack of the splenic tissue itself is sometimes sufficient to bring about the rupture. The present case of atraumatic splenic rupture on spleen sepsis, no abscess, starting from a pulmonar infection with Streptococcus pneumoniae is, to our knowledge, the first case reported in literature.
感染性疾病过程中发生的非创伤性脾破裂虽罕见,但已有报道。多种病毒均可引发此类破裂。最常被提及的病毒性疾病是传染性单核细胞增多症。较常涉及的细菌有非肺炎链球菌、假单胞菌、葡萄球菌和梭状芽孢杆菌。破裂机制尚未完全阐明;可能与败血症通过血行途径扩散至脾脏并导致脾肿大有关。败血症后的脾破裂并不总是伴有明显的脾肿大或脓肿形成,但有时脾脏组织自身受到侵袭就足以导致破裂。据我们所知,本病例为因肺炎链球菌肺部感染引发的无脓肿的脾脏败血症导致的非创伤性脾破裂,是文献报道中的首例。