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Splenic Hematoma

Splenic Haematoma


Presentation

  • 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]
  • We describe the presentation and the clinical progress of a case in whom a sudden enlargement in hematoma's diameter needed a splenectomy to avoid the risk of blood effusion in the abdominal cavity.[ncbi.nlm.nih.gov]
  • We present a patient with a known history of intravenous drug abuse and recent abdominal trauma who was found to have infective endocarditis and subsequently an infected splenic hematoma. The related literature is also discussed.[ncbi.nlm.nih.gov]
  • Abstract A 7-day-old hemophilic newborn presented several hemorrhagic manifestations, notably a large cephalohematoma, intracranial hemorrhage and a splenic hematoma.[ncbi.nlm.nih.gov]
  • Particular care should be taken when a patient presents with a cystic mass in the region of the spleen and a history of chronic alcohol abuse, regardless of the presence or absence of a history of a traumatic episode.[ncbi.nlm.nih.gov]
Splenomegaly
  • CONCLUSIONS: Although filgrastim-induced splenomegaly, splenic hematomas, and splenic rupture are rare, clinicians working in the bone marrow transplant setting should be cognizant of the potential of growth factors to cause these adverse events.[ncbi.nlm.nih.gov]
  • Especially in cases with splenomegaly, the laparoscopic approach results in a shorter hospital stay and faster recovery of the patients.[ncbi.nlm.nih.gov]
  • 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]
  • However, patients with splenomegaly due to anemia like the one discussed above are more vulnerable to splenic trauma.[e-ultrasonography.org]
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
  • 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]
  • Case Report A 35 years male was admitted with abdominal pain, tachycardia, hypotension, pallor and anaemia (Hb – 5.0 gm/ dl). Physical examination revealed fullness and tenderness in the left hypochondrium.[tropicalgastro.com]
  • 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]
  • Patients often have abdominal pain, sometimes radiating to the shoulder, and tenderness. Diagnosis is made by CT or ultrasonography. Treatment is with observation and sometimes surgical repair; rarely, splenectomy is necessary.[merckmanuals.com]
  • Because the patient in this case was hemodynamically stable, had no signs of infection, refused surgical treatment due to the fear of complications, US-guided percutaneous drainage was performed to alleviate the abdominal pain and decompress the expanding[synapse.koreamed.org]
Left Upper Quadrant Pain
  • 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]
  • She was admitted with epigastric and left upper quadrant pain of two days duration. She had an attack of mild acute pancreatitis of unknown aetiology three months previously.[joplink.net]
  • Patients with unexplained left upper quadrant pain, particularly if there is evidence of hypovolemia or shock, are generally inquired regarding any recent trauma. [1] The primary concern in any splenic trauma is internal hemorrhage, though the exact amount[en.wikipedia.org]
  • 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 Flank Pain
  • However, on the sixth day, the patient complained of a sudden onset of severe left flank pain not relieved by analgesics, and the hemoglobin levels were decreased (9.7 g/dL). However, there was no hypotension.[synapse.koreamed.org]
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]
  • Shoulder Pain Fever Unreliable abdominal examination (e.g.[fpnotebook.com]
  • shoulder pain (Kehr’s Sign) Kehr's sign: Pain in the left shoulder caused by irritation of the undersurface of the diaphragm by blood leaking from a ruptured spleen.[physio-pedia.com]

Workup

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]

Treatment

  • Radical treatment comprised exercsis of the cystic structure, splenectomy and caudal pancreatectomy.[ncbi.nlm.nih.gov]
  • The patient was referred to another hospital for conservative treatment in the outpatient clinic.[ncbi.nlm.nih.gov]
  • treatment option for the subcapsular splenic hematoma complicating a pancreatic pseudocyst in a patient with multiple episodes of pancreatitis.[synapse.koreamed.org]
  • They suggested that treatment of splenic hematoma should be splenectomy in majority of patients to prevent continuing blood loss and potential rupture.[ 5 ] Percutaneous drainage for splenic subcapsular collections may be a feasible treatment, but there[tropicalgastro.com]
  • [ edit ] Treatment has traditionally been splenectomy.[en.wikipedia.org]

Prognosis

  • 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]

Etiology

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

Pathophysiology

  • […] 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]

Prevention

  • 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]
  • They suggested that treatment of splenic hematoma should be splenectomy in majority of patients to prevent continuing blood loss and potential rupture.[ 5 ] Percutaneous drainage for splenic subcapsular collections may be a feasible treatment, but there[tropicalgastro.com]
  • 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]
  • After a splenectomy, certain precautions are needed to prevent infections (see Asplenia ).[merckmanuals.com]
  • This is a key anatomical feature that helps prevent injuries from causing massive blood loss.[en.wikipedia.org]

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