Ferrara F, D'Ambrosio V, Di Noto R, Mele G, Giovine S, Romano L
Divisione di Ematologia, Ospedale A. Cardarelli, Napoli, Italy.
Leuk Lymphoma. 1998 May;29(5-6):613-6. doi: 10.3109/10428199809050921.
We describe a case of spontaneous splenic rupture occurred in a patient with acute lymphoblastic leukemia of Burkitt type before starting cytotoxic chemotherapy. Left hypochondrial pain radiating to the homolateral shoulder was the only clinical symptom. Emergency computed tomography showed splenic laceration and hemoperitoneum. The patient underwent immediate laparatomy with splenectomy and experienced an uneventful postoperative recovery. Eight days after surgery, chemotherapy could be administered and complete remission was achieved. Although spontaneous rupture of the spleen is rare in leukemia and related disorders, this diagnosis should be taken in account also when clinical symptoms are mild. Following immediate operative management, patients may completely recover and receive cytotoxic chemotherapy with substantial possibilities of achieving complete remission.
我们描述了一例在开始细胞毒性化疗前发生自发性脾破裂的伯基特型急性淋巴细胞白血病患者。左侧季肋部疼痛放射至同侧肩部是唯一的临床症状。急诊计算机断层扫描显示脾破裂和腹腔积血。患者立即接受了剖腹脾切除术，术后恢复顺利。术后8天开始进行化疗，并实现了完全缓解。虽然白血病及相关疾病中脾脏自发性破裂很少见，但即使临床症状较轻也应考虑到这一诊断。经过立即手术治疗，患者可能完全康复并接受细胞毒性化疗，有很大可能实现完全缓解。
