Spontaneous splenic rupture following lung volume reduction surgery: an interesting clinical entity

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Excerpt

A 51‐year‐old woman with severe chronic obstructive pulmonary disease underwent bilateral video‐assisted thoracoscopic lung volume reduction surgery. She had a past history of idiopathic thrombocytopenic purpura. Her post‐operative course was unremarkable. She developed sudden onset abdominal pain and haemorrhagic shock on post‐operative day 18. A contrast computed tomographic scan revealed large haemoperitoneum and splenic haematoma (Fig. 1a). Selective angiography demonstrated dye ‘blush’ and confirmed active bleeding from the splenic artery (Fig. 1b), which required multiple coil embolizations (Fig. 1c). The patient made an uncomplicated recovery and was discharged home on post‐operative day 24.
Atraumatic splenic rupture is a rare and life‐threatening clinic‐pathological condition, which is usually associated with underlying splenic pathology. Early recognition of the condition is vital as urgent splenectomy is often required for management. Spontaneous splenic rupture has rarely been reported following thoracic surgery.1 Splenic rupture should be considered as a differential diagnosis in patients displaying clinical features of bleeding post‐operatively with pre‐existing splenic abnormality.
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