In the present study, we aim to share our clinical experience in patients with spontaneous
splenic rupture.
Splenic rupture without
trauma is known as spontaneous
splenic rupture. The major problems in the management of spontaneous
splenic rupture are missed or delayed diagnosis due to the lack of
trauma in most cases. The records of all patients, who were admitted to Cerrahpaşa Medical Faculty, Istanbul University, were retrospectively reviewed from January 2000 to March 2013. Twelve patients were admitted to the emergency department and they were diagnosed with spontaneous
splenic rupture. The mean age was 47.6 years. All patients had complaints of
abdominal pain. The mean hematocrit value was 22%. Radiologic assessment revealed
hemoperitoneum and/or subcapsular
hematoma in 8 patients while splenic
abscess was diagnosed in 2 patients. Eleven patients underwent
splenectomy whereas one was managed conservatively. The most common cause of spontaneous
splenic rupture was determined to be use of
anticoagulants. Etiology was considered to be idiopathic in 1 patient. Two patients died in the postoperative period. Although rare, spontaneous
splenic rupture must be suspected in emergency patients who have used especially
anticoagulants and antiaggregants and who have had no recent history of
trauma. One of the important causes of mortality is missed or delayed diagnosis.