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A case of splenic rupture: a rare event after laparoscopic cholecystectomy.

Authors :
Girolamo, Geraci
Picciurro, Antonino
Attard, Andrea
Modica, Giuseppe
Cajozzo, Massimo
Sciumè, Carmelo
Source :
BMC Surgery; 2014, Vol. 14 Issue 1, p56-65, 10p
Publication Year :
2014

Abstract

Background Laparoscopic cholecystectomy (LC) is generally safe and well-accepted. In rare cases, it is associated with complications (intra- e postoperative bleeding, visceral injury and surgical site infection). Splenic lesion has been reported only after direct trauma. We report an unusual case of splenic rupture presenting after "uncomplicated" LC. Case presentation A 77-year-old woman presented with distended abdomen, tenderness in the left upper quadrant and severe anemia 12 hours after LC. Clinical examination revealed hypovolemic shock. Abdominal computed tomography confirmed the diagnosis of splenic rupture, and the patient required an urgent splenectomy through midline incision. The post-operative course was uneventful and the patient was discharged on 7th postoperative day. Splenic injury rarely complicates LC. We postulate that congenital or post-traumatic adhesions of the parietal peritoneum to the spleen may have been stretched from the splenic capsule during pneumoperitoneum establishment, resulting in subcapsular hematoma and subsequent delayed rupture. Conclusions Splenic rupture is an unusual but life-threatening complication of LC. Direct visualization of the spleen at the end of LC might be a useful procedure to aid early recognition and management in such cases. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14712482
Volume :
14
Issue :
1
Database :
Complementary Index
Journal :
BMC Surgery
Publication Type :
Academic Journal
Accession number :
100366505
Full Text :
https://doi.org/10.1186/1471-2482-14-106