Spontaneous splenic rupture in a patient receiving thrombolytic therapy

We describe the case of a 67-year-old female patient with a history of femoral-distal bypass graft with sudden onset of unremitting leg pain, who had recently received tissue plasminogen activator (t-PA). The patient reported non-compliance with her warfarin regimen. Angiography revealed occlusion of the bypass graft. Infusion of t-PA was performed via a right femoral artery approach. On hospital day two, the patient developed nausea and abdominal pain with associated hypotension. A CT scan showed a massive intra-abdominal and pelvic free fluid consistent with blood. The spleen was enlarged and fluid noted around the liver. At laparotomy, a grade III splenic laceration at the hilum was identified and a splenectomy performed. The patient recovered completely. Although rare, spontaneous splenic rupture should be considered in the differential diagnosis of patients undergoing thrombolytic therapy who develop signs of hemodynamic instability.

Bibliographic Details

Main Authors:	Revesz,Elizabeth, Grimaldi,John A., Clark,Elizabeth T., Podbielski,Francis J.
Format:	Digital revista
Language:	English
Published:	Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2009
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492009000300016
Tags:	Add Tag No Tags, Be the first to tag this record!