The presentation of spontaneous splenic rupture in a COVID-19 patient: a case report
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CASE REPORT
Open Access
The presentation of spontaneous splenic rupture in a COVID-19 patient: a case report Mohammadreza Mobayen, Saeed Yousefi, Mohammadsadegh Mousavi* and Amin Shafighi Anbaran
Abstract Background: Splenic rupture is an emergency condition and a vast number of cases are secondary to trauma. Several underlying pathologies have also been associated with splenic rupture, such as hematological diseases, malignancies, and infectious and inflammatory diseases. Case presentation: The patient was a 52-year-old man who referred to the Poursina Hospital in Rasht while complaining of abdominal pain from the day before hospitalization. The patient reported a history of lethargy, fever, and nausea. In the examinations performed, there was a brief tenderness in the patient’s epigastrium. The patient was monitored and about 12 h after hospitalization, ill appearance, respiratory (respiratory distress) symptoms, and high fever were reported for the patient. According to the examination, the patient was immediately transferred to the operating room and underwent laparotomy. During the operation, contrary to our expectations, a lot of blood (about 1000 cc) was observed in the patient’s abdomen. After blood suctioning, the left upper quadrant (LUQ) was bleeding and the rupture of the spleen could also be observed. Therefore, a splenectomy was performed. In the examinations performed for the patient, the patient’s rtPCR test confirmed COVID-19. Conclusion: The evaluation of the spontaneous splenic rupture (SSR) in our case shows that this type of risk should also be considered in patients with COVID-19 who refer to medical centers with abdominal pain, and if more cases are reported, the correctness of this process can be commented on. Keywords: Case report, Surgery, Spleen, COVID-19
Background Splenic rupture is an emergency condition and a vast number of cases are secondary to trauma. Several underlying pathologies have also been associated with splenic rupture, such as hematological diseases, malignancies, and infectious and inflammatory diseases [1–3]. Atraumatic splenic rupture (ASR) is rare [1, 2]. Splenic rupture is not considered in the differential diagnosis of abdominal pain in the absence of trauma, the results of which may be catastrophic [4]. * Correspondence: [email protected] Department of General Surgery, Guilan University of Medical Sciences, Rasht, Iran
The diagnosis of splenic rupture is a clinical finding confirmed by either Computed tomography scan (CT scan) or laparotomy (in hemodynamically unstable patients). Several grading systems have been established for splenic rupture based on CT scan or ultrasound findings and each has been found to be effective in contributing to management and decision making [4]. However, there has been a tremendous amount of case reports of atraumatic splenic rupture, there are not any comprehensive assessment to reveal the incidence rate, causes, specific symptoms, available management methods, and the prognosis [3].
© The Author(s). 2020 Open Access
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