Yonsei Med J.  2005 Jun;46(3):435-438. 10.3349/ymj.2005.46.3.435.

Spontaneous Splenic Rupture in a Hemodialysis Patient

• Kim HJ
• Lee GW
• Park DJ
• Lee JD
• Chang SH

• KMID: 1734081
• DOI: http://doi.org/10.3349/ymj.2005.46.3.435

Abstract

Spontaneous splenic rupture (SSR) in a patient undergoing hemodialysis has been described as an extremely rare and potentially fatal complication. We report here spontaneous splenic rupture in a 52-year-old woman undergoing regular hemodialysis for end-stage renal disease (ESRD). She complained of colicky abdominal pain in the left upper quadrant area and dizziness when she assumed an upright posture. Her vital signs revealed low blood pressure and tachycardia, which was suggestive of hypovolemic shock. Abdomen CT scan showed splenic hematoma and hemoperitoneum. However, she had no history of any event triggering the splenic rupture. An exploratory laparotomy showed a ruptured spleen and an emergency splenectomy was performed. We suggest that spontaneous spleen rupture may be attributed to uremic coagulopathy and heparin-induced coagulopathy.

Keyword

Splenic rupture; chronic renal failure; hemodialysis; uremic coagulopathy

MeSH Terms

Female
Humans
Kidney Failure, Chronic/*complications
Middle Aged
*Renal Dialysis
Rupture, Spontaneous
Spleen/*pathology
Splenic Diseases/*complications/*pathology

Figure

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  Fig. 1 Abdominal CT scan on the preoperative state showing splenic hematoma with spontaneous hemoperitoneum.

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  Fig. 2 Pathologic finding: Normal spleen tissue with hematoma (H&E stain, ×400).

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