Herein, we report on a senile female with blunt abdominal trauma 6 years previous, who turned out to have a calcified splenic hematoma with clinical presentations of a palpable pelvic mass and intestinal obstruction. [tmu.pure.elsevier.com]

The present study report a two day old infant who presented to us in shok with severe pallor and abdominal distension. [ncbi.nlm.nih.gov]

• Localized Pain

  Local pain was encountered in 12 (26.6%) and lasted for a mean (+/- SD) of 7 +/- 3.8 hours. Local tenderness was noted in 17 (37.7%) and lasted for 6.8 +/- 3.7 hours. [ncbi.nlm.nih.gov]

• Splenomegaly

  Especially in cases with splenomegaly, the laparoscopic approach results in a shorter hospital stay and faster recovery of the patients. [ncbi.nlm.nih.gov]

  However, patients with splenomegaly due to anemia like the one discussed above are more vulnerable to splenic trauma. [e-ultrasonography.org]

  Hypersplenism (Medical Encyclopedia) Spleen removal (Medical Encyclopedia) Spleen removal - laparoscopic - adults - discharge (Medical Encyclopedia) Spleen removal - open - adults - discharge (Medical Encyclopedia) Splenomegaly (Medical Encyclopedia) [icdlist.com]

  D73.3 Abscess of spleen D73.5 Infarction of spleen D73.8 Other diseases of spleen D73.81 Neutropenic splenomegaly D73.89 Other diseases of spleen D73.9 Disease of spleen, unspecified D74 Methemoglobinemia D74.0 Congenital methemoglobinemia D74.8 Other [icd10data.com]

• Massive Splenomegaly

  In the past decade, laparoscopy has become the standard approach for elective splenectomy, even for patients such as ours, presenting with massive splenomegaly and hematoma [9]. [ncbi.nlm.nih.gov]

• Chest Wall Pain

  The patient was subsequently rechallenged with filgrastim, which led to recurrence of the left-sided chest-wall pain. Filgrastim was discontinued and the patient reported resolution of the pain. [ncbi.nlm.nih.gov]

• Abdominal Pain

  Importance of considering splenic hematoma and/or rupture if abdominal pain occurs in the course of mononucleosis syndrome is outlined as well as importance of routine laboratory tests in suspecting mononucleosis syndrome in otherwise clinically silent [ncbi.nlm.nih.gov]

  […] imaging in a patient with unexplained abdominal pain or symptoms of hemodynamic instability after colonoscopy. [aafp.org]

  We report a 59 years old male who presented an acute abdominal pain and dyspnea while staying at high altitude. Six days later, an angio CAT scan showed the presence of a subcapsular splenic hematoma that was managed conservatively. [revistamedicadechile.cl]

  This situation is practically asymptomatic or it causes a mild abdominal pain located in the left upper quadrant. The bleeding may stop, but if it continues, the hematoma enlarges and the capsule may suddenly rupture as well. [health-tutor.com]

  CASE 1 A 54-year-old male presented with acute onset of pain abdominal pain since one day in the left quadrant. He experienced nausea. No fever was reported. [abdominalsurg.org]

• Left Upper Quadrant Pain

  Important signs and symptoms that can suggest splenic involvement are increasing pain in the left upper quadrant and pain referred to the left shoulder [1, 9] or findings of a left upper quadrant mass on physical examination. [joplink.net]

  Minor hemorrhage often presents as upper left quadrant pain. [en.wikipedia.org]

  Patients with pancreatitis presenting with a mass in the left upper quadrant, pain radiating to the left shoulder, and a fall in haemoglobin should be suspected to have a hemorrhagic complication and urgently admitted. [tropicalgastro.com]

  Case Report A 14-year-old boy presented to the Emergency Department of our hospital complaining of left upper quadrant pain after an accident during which he fell onto his bicycle’s handlebars. [e-ultrasonography.org]

• Pelvic Mass

  Herein, we report on a senile female with blunt abdominal trauma 6 years previous, who turned out to have a calcified splenic hematoma with clinical presentations of a palpable pelvic mass and intestinal obstruction. [ncbi.nlm.nih.gov]

• Left Shoulder Pain

  […] pt complaining of left shoulder pain after abdominal trauma pt with noted rib fractures (it takes a lot of force to fracture those compliant pediatric ribs) pt with multi-trauma Unfortunately, a contained rupture may have few initial symptoms. [pedemmorsels.com]

  […] or left Shoulder Pain Fever Unreliable abdominal examination (e.g. [fpnotebook.com]

  in the upper left portion of the stomach (abdomen) or under rib cage Tenderness when you touch the upper left portion of the stomach (abdomen) Left shoulder pain (Kehr’s Sign) Kehr's sign: Pain in the left shoulder caused by irritation of the undersurface [physio-pedia.com]

  Scroll through the images and describe the findings On the left images of a 22-year old male who presented 3 hours after a snowboarding accident with LUQ and left shoulder pain. Scroll through the images and describe the lesions. Then continue. [radiologyassistant.nl]

Preoperative laboratory workup including Complete Blood Count, parasitic serologies and chemistries were within normal limits. Pneumovax 23™ 23-valent pneumococcal polysaccharide vaccine was administered 2 weeks prior to the planned splenectomy. [ncbi.nlm.nih.gov]

Left lower rib fracture is present in 44% of patients with splenic rupture and necessitates further workup by abdominal CT. [emedicine.medscape.com]

• Thrombocytosis

  (see differential diagnoses below) References: [3] Diagnostics Laboratory tests : low Hb, leukocytosis, and thrombocytosis ; crossmatch for blood transfusion if needed In hemodynamically unstable patients First ultrasound : focused assessment with sonography [amboss.com]

Despite the initial conservative treatment consisting of pain control, bowel rest, intravenous fluids and antibiotics, the pain was not relieved. [ncbi.nlm.nih.gov]

The follow-up and treatment of splenic complications should not be similar to the follow-up and treatment of traumatic subcapsular hematoma, follow up criteria must be defined and keeping the next probable pancreatitis attack in mind radical treatment [turkjsurg.com]

treatment option for the subcapsular splenic hematoma complicating a pancreatic pseudocyst in a patient with multiple episodes of pancreatitis. [synapse.koreamed.org]

Abstract A male Japanese Tosa Dog 7years old with large spleen hematoma was rescued successfully from bad prognosis by surgical removal. Before clinical observation and surgery, this case was diagnosed as sever canine filariasis. [jstage.jst.go.jp]

[…] lobulation of the spleen after development in contrast to a laceration, a cleft is usually smooth with a rounded edge and are not associated with an adjacent subcapsular hematoma or perisplenic fluid some larger clefts may contain fat Treatment and prognosis [radiopaedia.org]

Splenic infarct • Splenic cyst • Lymphoma and splenic tumors CLINICAL ISSUES • Most commonly injured solid abdominal organ in blunt trauma and most common abdominal organ injury requiring surgery • Prone to develop delayed hemorrhage, but excellent prognosis [clinicalgate.com]

Prognosis The ample blood supply to the spleen can promote rapid healing. Studies have shown that intra-abdominal bleeding associated with splenic trauma stops without surgical intervention in up to two out of three cases in children. [medical-dictionary.thefreedictionary.com]

The location of a hematoma plays a role in its prognosis. From Reviewed by: Tova Alladice, M.D. American Board of Physical Medicine & Rehabilitation [rxlist.com]

In the absence of local factors, the etiology of splenic hemorrhage remains unknown. [ncbi.nlm.nih.gov]

As is seen in our case, the risk of splenic rupture should not be ignored before elimination of the etiology. [turkjsurg.com]

Anatomy and etiology The spleen is a functionally complex organ occupying the left upper quadrant (LUQ). It is an intraperitoneal organ weighing 75-100 g in the adult. [emedicine.medscape.com]

Etiology Blunt abdominal trauma Most frequently caused by m otor vehicle accidents leading to liver and spleen injury Also caused by falls from high heights ;, domestic violence, and sport-related trauma Other causes Left-sided thoracic trauma with fractures [amboss.com]

Laceration of greater than 3 cm in depth or involving trabecular vessels. [15] Grade V - Shattered spleen or hilar vascular injury [15] Etiology/Causes Traumatic (common) [3] • Injury or blow to left side of the body (left upper abdomen or left lower [physio-pedia.com]

Mellouki 2, Dafr Allah Benajeh 2, Meriem Bobo 3, Hicham Bohadouti 4, Siham Tizniti 3, Adil Ibrahimi 2, Khalid Ait Taleb 4, Nabil Kanjaa 1 Publication date (Electronic): 31 July 2015 Journal: The Pan African Medical Journal Publisher: The African Field Epidemiology [scienceopen.com]

[…] splenic salvage maneuver Grade IV Fragmented spleen with major devascularization Surgical intervention: splenectomy, a partial splenic resection if possible Grade V Hilar laceration/shattered spleen Surgical intervention: splenectomy References: [2] Pathophysiology [amboss.com]

Abstract The use of a nasogastric tube to empty the stomach contents prevents compression of the splenic parenchyma and allows clear visualization of the anterior medial border of the spleen and perisplenic area. [ncbi.nlm.nih.gov]

Can a hematoma be prevented? Prevention of all hematomas is not entirely possible. However, prevention of hematomas in certain contexts deserves special attention. [rxlist.com]

Centers for Disease Control and Prevention. https://www.cdc.gov/epstein-barr/about-mono.html. Published September 14, 2016. Accessed April 5, 2017 ↑ Infectious Mononucleosis Differential Diagnoses. [physio-pedia.com]

A more aggressive approach, early splenectomy, has also been advocated for the treatment of splenic hematoma in order to prevent blood loss and potential splenic rupture [1, 8, 10]. [turkjsurg.com]

After a splenectomy, certain precautions are needed to prevent infections (see Asplenia ). [merckmanuals.com]