Background Laparoscopic cholecystectomy (LC) is generally safe and well-accepted. In rare cases, it is associated with complications (intra- e postoperative bleeding, visceral injury and surgical site infection). Splenic lesion has been reported only after direct trauma. We report an unusual case of splenic rupture presenting after “uncomplicated” LC. Case presentation A 77-year-old woman presented with distended abdomen, tenderness in the left upper quadrant and severe anemia 12 hours after LC. Clinical examination revealed hypovolemic shock. Abdominal computed tomography confirmed the diagnosis of splenic rupture, and the patient required an urgent splenectomy through midline incision. The post-operative course was uneventful and the patient was discharged on 7th postoperative day. Splenic injury rarely complicates LC. We postulate that congenital or post-traumatic adhesions of the parietal peritoneum to the spleen may have been stretched from the splenic capsule during pneumoperitoneum establishment, resulting in subcapsular hematoma and subsequent delayed rupture. Conclusions Splenic rupture is an unusual but life-threatening complication of LC. Direct visualization of the spleen at the end of LC might be a useful procedure to aid early recognition and management in such cases.

Geraci, G., Picciurro, A., Attard, A., Modica, G., Cajozzo, M., Sciume', C. (2014). A case of splenic rupture: a rare event after laparoscopic cholecystectomy. BMC SURGERY, 106(14) [doi:10.1186/1471-2482-14-106].

A case of splenic rupture: a rare event after laparoscopic cholecystectomy

GERACI, Girolamo;PICCIURRO, Antonino;ATTARD, Andrea;MODICA, Giuseppe;CAJOZZO, Massimo;SCIUME', Carmelo
2014-01-01

Abstract

Background Laparoscopic cholecystectomy (LC) is generally safe and well-accepted. In rare cases, it is associated with complications (intra- e postoperative bleeding, visceral injury and surgical site infection). Splenic lesion has been reported only after direct trauma. We report an unusual case of splenic rupture presenting after “uncomplicated” LC. Case presentation A 77-year-old woman presented with distended abdomen, tenderness in the left upper quadrant and severe anemia 12 hours after LC. Clinical examination revealed hypovolemic shock. Abdominal computed tomography confirmed the diagnosis of splenic rupture, and the patient required an urgent splenectomy through midline incision. The post-operative course was uneventful and the patient was discharged on 7th postoperative day. Splenic injury rarely complicates LC. We postulate that congenital or post-traumatic adhesions of the parietal peritoneum to the spleen may have been stretched from the splenic capsule during pneumoperitoneum establishment, resulting in subcapsular hematoma and subsequent delayed rupture. Conclusions Splenic rupture is an unusual but life-threatening complication of LC. Direct visualization of the spleen at the end of LC might be a useful procedure to aid early recognition and management in such cases.
2014
Settore MED/18 - Chirurgia Generale
http://www.biomedcentral.com/content/pdf/1471-2482-14-106.pdf
Geraci, G., Picciurro, A., Attard, A., Modica, G., Cajozzo, M., Sciume', C. (2014). A case of splenic rupture: a rare event after laparoscopic cholecystectomy. BMC SURGERY, 106(14) [doi:10.1186/1471-2482-14-106].
File in questo prodotto:
File Dimensione Formato  
A case of splenic rupture_a rare event after laparoscopic cholecystectomy_2014.pdf

accesso aperto

Descrizione: Articolo
Dimensione 964.52 kB
Formato Adobe PDF
964.52 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/103539
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 3
social impact