Splenic rupture following laparoscopic salpingectomy

Acute splenic rupture following laparoscopic pneumoperitoneum: A case report

Introduction

Splenic rupture after laparoscopic surgery is a very rare complication. In this study, we report a case of a splenic laceration that occurred during a laparoscopic gastrostomy tube placement. The theorized mechanism in this case was acute disruption of a peri-splenic hematoma.

Case report

A 64-year-old African-American male presented after a motor vehicle accident with multiple injuries and was admitted to a surgical intensive care unit, where he declined from ICU days 6 through 11. The patient underwent tracheostomy and laparoscopic gastrostomy tube placement given his significant neurologic deficits. Intraoperatively, the patient developed hypotension, leading to the discovery of hemoperitoneum and necessitating an emergent open splenectomy.

Conclusion

Splenic rupture following laparoscopic procedures is a very rare phenomenon. In this case, we believe the splenic rupture was secondary to an acute disruption of a previously hemostatic splenic hematoma involving the abdominal wall during creation of capnoperitoneum.

Splenic rupture after laparoscopic surgery: a case report

Splenic rupture is a rare and severe complication of laparoscopic surgery. We report a case of delayed splenic rupture as a severe complication of laparoscopy, occurring 5 days after surgery performed on a 52-year-old woman with history of abdominal surgery and with acute pelvic infection. Subcapsular hematoma, resulting in splenic rupture, may have been a result of overlooked puncture by the Veress needle or by tension on splenic adhesions during lysis. The diagnosis should be brought up during postoperative care in case of severe pain with hemodynamic failure, hemoglobin concentration decrease, or both.