Splenic rupture

Case contributed by Dr Fabio Macori

Presentation

Patient with a history of chronic lymphocytic leukaemia (CLL) underwent a scheduled abdominal CT for restaging.

Patient Data

Age: 80
Gender: Female
CT

The images in non-contrast CT show an enlarged spleen. It seems that a subtle line of hypodensity is visible in the lower pole.

After contrast media, a narrow well-defined hypoattenuating area is shown in the lower third of the spleen. A subcapsular haematoma is present.

Subtle fluid is evident in the pouch of Douglas.

Case Discussion

This case illustrates a splenic rupture after a presumed minor trauma.

The patient with a history of chronic lymphocytic leukaemia (CLL) has mentioned she fell down few days before the procedure.

There is evidence of splenomegaly, which can explain the rupture even if the trauma was only minor. 

The patient due to her underlying pathology, the injury was considered as unstable and for this reason, the patient underwent surgical admission for monitoring and then splenectomy was the treatment of choice. 

The patient is now in good health.

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Case information

rID: 56567
Case created: 9th Nov 2017
Last edited: 17th Nov 2017
System: Haematology
Inclusion in quiz mode: Included
Institution: ospedale nuovo regina margherita

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