Nam R, Carr M M, Jamieson C G
Department of Surgery, Wellesley Hospital, University of Toronto, Ont.
Can J Surg. 1996 Apr;39(2):151-4.
Delayed rupture of the spleen is a rare but serious complication of blunt abdominal trauma. A 47-year-old woman with a history of fractured pelvis from a motor vehicle accident 6 months earlier presented with evidence of a myocardial infarction. Subsequent streptokinase administration was complicated by splenic rupture, which was managed by evacuation of the clotted blood and splenectomy. The patient made a complete recovery. The risk of splenic rupture and bleeding complications resulting from thrombolytic therapy for myocardial infarction is discussed, as are the controversy over whether delayed splenic rupture is a true diagnosis, the mechanism of rupture and the clues to impending rupture.
脾延迟破裂是钝性腹部创伤中一种罕见但严重的并发症。一名47岁女性，6个月前因机动车事故导致骨盆骨折，现出现心肌梗死迹象。随后使用链激酶治疗引发了脾破裂，通过清除凝血块和脾切除术进行处理。患者完全康复。本文讨论了心肌梗死溶栓治疗导致脾破裂和出血并发症的风险，以及关于延迟性脾破裂是否为真正诊断、破裂机制和即将破裂的线索的争议。
