Korean J Med.  2015 Nov;89(5):585-588. 10.3904/kjm.2015.89.5.585.

Successful Transcatheter Embolization of Spontaneous Splenic Rupture in a Patient with Chronic Myeloid Leukemia

• Moon JY
• Kim JM
• Kwon KC
• Shin BS
• Ohm JY
• Jo DY
• Song IC

• KMID: 2268963
• DOI: http://doi.org/10.3904/kjm.2015.89.5.585

Abstract

We report a rare case of a patient who presented with pathological splenic rupture as the initial manifestation of chronic myeloid leukemia (CML) and was treated successfully by transcatheter arterial embolization. A 36-year-old man presented to the emergency department with a 1-day history of abdominal pain. Computed tomography showed gross hemoperitoneum with marked splenomegaly, with suspected focal rupture at the lower portion of the spleen and the extravasation of contrast material indicating active bleeding. Given the patient's hemodynamic stability, he was treated with partial splenic embolization by an interventional radiologist, and transfused with red blood cells. Examination of a bone marrow aspiration and biopsy led to a diagnosis of chronic phase CML. He was discharged from the hospital on day 13 post-embolization. Transcatheter arterial embolization should be considered as the initial treatment of spontaneous splenic rupture, especially in patients with hematological malignancies.

Keyword

Chronic myeloid leukemia; Splenic rupture; Therapeutic embolization

MeSH Terms

Abdominal Pain
Adult
Biopsy
Bone Marrow
Diagnosis
Embolization, Therapeutic
Emergency Service, Hospital
Erythrocytes
Hematologic Neoplasms
Hemodynamics
Hemoperitoneum
Hemorrhage
Humans
Leukemia, Myelogenous, Chronic, BCR-ABL Positive*
Rupture
Spleen
Splenic Rupture*
Splenomegaly