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Acute pancreatitis complicated with splenic rupture: A case report

World Journal of Gastrointestinal Surgery 2015年第9期7卷 219-222页

作者： Bruno L Hernani Pedro C Silva ricardo t nishio Henrique C Mateus José C Assef tercio De Campos Irmandade da Santa Casa de Misericórdia de Sao Paulo Hospital Santa Casa School of Medicine Department of Surgery Emergency UnitIrmandade da Santa Casa de Sao Paulo HospitalSanta Casa School of Medicine

Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. this report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. the patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography(Ct) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventytwo hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A Ct angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. the patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.

关键词： Acute pancreatitis Pancreatitis Rupture Splenic rupture Spontaneous

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