Lee Ramos J, Farr M, Shin SH, Ahmed N. Atraumatic splenic rupture in young adult following cocaine use.
Int J Surg Case Rep 2019;
65:168-170. [PMID:
31715447 PMCID:
PMC6849116 DOI:
10.1016/j.ijscr.2019.10.081]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION
Splenic rupture most commonly results from a traumatic mechanism. Spontaneous splenic ruptures are a rare occurrence. This is an interesting and rare case of atraumatic splenic rupture (ASR) presented after sniffing cocaine.
PRESENTATION OF CASE
The patient presented with abdominal pain and tenderness with low hemoglobin on admission. The computed tomography (CT) scan of the abdomen showed possible spleen rupture with hemoperitoneum. An emergent laparotomy and total splenectomy was performed. The pathology confirmed splenomegaly and a large area of adhesion. Adjacent to the adhesion, a focal disruption of splenic parenchyma was found.
DISCUSSION
ASR has been reported in the literature due to infection, inflammation, mechanical and use of certain drugs. Few cases of ASR have been described due to cocaine use. Splenomegaly is one of the risk factors of ASR. The most probable mechanism of ASR in cocaine use is sudden vasoconstriction, ischemia and infarction of the parenchyma of the spleen, which can result in vascular rupture. Our case of ASR echoes the above process.
CONCLUSION
Total splenectomy resulted in a good outcome. The patient was discharged home without any services.
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