Korean J Med.  2019 Dec;94(6):526-529. 10.3904/kjm.2019.94.6.526.

Spontaneous Splenic Rupture in a Peritoneal Dialysis Patient

• Lee SH
• Lee DY
• Moon KH
• Kim HJ
• Lee MJ
• Kim HS
• Kim B

• KMID: 2467219
• DOI: http://doi.org/10.3904/kjm.2019.94.6.526

Abstract

Atraumatic splenic rupture (ASR) in a patient undergoing peritoneal dialysis (PD) is uncommon, but can be life-threatening. According to recent systematic reviews, the major causes of ASR are 1) neoplastic (30.3%), 2) infectious (27.3%), 3) non-infectious inflammatory (20.0%), 4) iatrogenic (9.2%), 5) mechanical (6.8%), and 6) idiopathic (6.4%). It is diagnosed by imaging studies, most commonly ultrasonography and computed tomography (CT). Due to its rarity, the early diagnosis of ASR is difficult, and no standard treatment has been described. Here, we report a case of idiopathic ASR in a patient undergoing PD. The diagnosis was established by abdominal CT scan, and splenectomy was performed. Thus, hemoperitoneum in a PD patient should raise suspicion of ASR. Early diagnosis and appropriate treatment will lead to a better outcome.

Keyword

Hemoperitoneum; Atraumatic splenic rupture; Peritoneal dialysis

MeSH Terms

Diagnosis
Early Diagnosis
Hemoperitoneum
Humans
Peritoneal Dialysis*
Splenectomy
Splenic Rupture*
Tomography, X-Ray Computed
Ultrasonography