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]

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]

• Splenectomy

  During recent years, laparoscopic splenectomy has shown to be a safe and effective surgical approach in patients with hematologic disorders requiring spleen removal. [ncbi.nlm.nih.gov]

  Two patients underwent emergency splenectomy, 2 patients received delayed splenectomy, and the others were treated conservatively. Time for healing of splenic lesions varied from 1 week to 4 months. [tropicalgastro.com]

• Infectious Mononucleosis

  Spontaneous subcapsular splenic hematoma formation without rupture in infectious mononucleosis is a very unusual occurrence. A conservative management is successful in those patients in stable condition. [ncbi.nlm.nih.gov]

  Associations abdominal: splenic trauma 3, a subcapsular hematoma is part of imaging criteria for grades I-III of the AAST splenic injury grading system infectious mononucleosis 1 pancreatitis 2,5 cocaine use 7 Radiographic features CT Imaging in the portal [radiopaedia.org]

  Accessed April 5, 2017 ↑ Infectious Mononucleosis Differential Diagnoses. Infectious Mononucleosis DifferentialfckLRDiagnoses. http://emedicine.medscape.com/article/222040-differential. Published January 6,fckLR2017. [physio-pedia.com]

  Definition / general Due to blunt trauma or abdominal surgery, causing hemoperitoneum and emergency splenectomy Only rarely ruptures spontaneously (associated with acute splenitis, amyloidosis [rare], infectious mononucleosis, inflammatory disorders, [pathologyoutlines.com]

  Enlargement of the spleen (for example, due to Epstein-Barr virus causing infectious mononucleosis ) makes the spleen more susceptible to injury. When the spleen is injured, blood may be released into the abdomen. [merckmanuals.com]

• 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]

  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]

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

• 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]

• Dyspnea

  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]

  The dyspnea did not decrease and the next step would be to use endotracheal intubation and ventilation. However, he clearly stated that considering his relatively short prognosis due to lung carcinoma he refused to be mechanically ventilated. [abdominalsurg.org]

• Sneezing

  Trauma to tissue also may be caused by an aggressive sneeze or an unexpected twist of an arm or leg. When a blood vessel is damaged, blood leaks into the surrounding tissue; this blood tends to coagulate or clot. [medicinenet.com]

• 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]

  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]

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

  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]

• Abdominal Guarding

  […] pain, especially in the left upper quadrant ( LUQ ), possible abdominal guarding Kehr's sign : referred pain in the left shoulder Ballance's sign: dullness on percussion in the LUQ Hemorrhagic shock (often delayed) : tachycardia and hypotension In delayed [amboss.com]

• Hypertension

  […] stroke-resistant spontaneously hypertensive rat) 脳卒中抵抗性高血圧自然発症ラット SSFP (steady state free precession) 定常状態自由歳差運動 SSRE (shear stress response element) ずり応力応答配列 [j-circ.or.jp]

  These include: Direct toxicity to spleen cells Pathological interference with the function of the immune system or liver Severe hemolysis Portal vein hypertension induced by hepatic toxicity of the drugs The drug-induced adverse reactions are usually [news-medical.net]

  In patients with splenic vein thrombosis and segmental portal hypertension, Malka et al. have suggested that the risk of splenic rupture is high and expectant management may be hazardous [1]. [joplink.net]

  In addition, it is emphasized that waiting for the resolution of splenic hematoma is risky due to segmental portal hypertension present during the course of chronic pancreatitis [ 4 ]. [turkjsurg.com]

  Associated Co-morbidities Common co-morbidities for traumatic splenic ruptures are hypertension, type II diabetes, and asthma. [physio-pedia.com]

• 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]

  Pain felt in the left shoulder as a result of a ruptured spleen is known as Kehr's sign. This feels worse when the individual breathes in. [medicalnewstoday.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]

• 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]

• Dizziness

  Cardiovascular instability such as dizziness and tachycardia because of intraperitoneal haemorrhage. [news-medical.net]

  They may experience symptoms such as a lasting headache, dizziness, or slurred speech. Anyone who has had an injury to the head or a severe injury elsewhere should see a doctor. When to see a doctor Many hematomas are simple. [medicalnewstoday.com]

  Splenic trauma may cause mild or severe internal bleeding, leading to shock and for which symptoms include rapid heartbeat, shortness of breath, thirst, pale or clammy skin, weak pulse, low blood pressure, dizziness, fainting, sweating. [medical-dictionary.thefreedictionary.com]

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]

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]

[…] 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]

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]

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