| A Case of Non-Surgical Treatment in Hemodialysis Patient with Spontaneous Splenic Rupture |
| Suk-Hee Yoo, M.D.1, Jae Geun Park, M.D.1, Sung Moo Kim, M.D.1, Jeong Eun Kim, M.D.1, Soon Kil Kwon, M.D.1, Jang-Whan Bae, M.D.1, Hye-young Kim, M.D.1 and Jin Uk Jeong, M.D.2 |
Department of Internal Medicine1 Chungbuk National University, Cheongju University of Ulsan College of Medicine2
Seoul, Korea |
| 증례 : 자발성 비장 파열이 발생한 혈액투석 환자에서 보존요법 치험 1예 |
| 유숙희1 , 박재근1 , 김성무1 , 김정은1 , 권순길1 , 배장환1 , 김혜영1 , 정진욱2 |
| 충북대학교 의과대학 내과학교실1 , 울산대학교 의과대학 내과학교실2 |
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| Abstract |
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Spontaneous splenic rupture is a rare disease but can cause a life threatening situation. It can occur under a pathological spleen such as infection, neoplastic, infiltrative and inflammatory disease. Although splenectomy is the treatment of choice for splenic rupture, it is uncertain that the effectiveness of nonsurgical treatment in the hemodynamically stable patient. We report a case of a 66-year-old male undergoing hemodialysis for 4 years who presented to the emergency department with abdominal pain and distention. Blood pressure was 130/80 mmHg, heart rate was 108 bpm. White blood cell count was 7,130/mm3, hemoglobin was 6.7 g/dL, platelet was 156,000/mm3. PT INR was elevated up to 2.01 because he had taken warfarin due to splenic infarction. Abdominal CT scan revealed hemoperitoneum due to splenic rupture. We performed angiography but there was no active bleeding. We decided conservative management without embolization because of stable condition and increased bleeding risk in operation. He received 6 pints of packed red blood cell transfusion during continuous renal replacement therapy for 24 hours on ICU. He was discharged with complete recovery on the 21st
hospital day. We suggest that non-surgical treatment in splenic rupture also could be considered in hemodynamically stable patients with a high risk of postoperative complication. |
| Key Words:
Splenic rupture, Renal dialysis |
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