Unbound MEDLINE

Traumatic splenectomy in a cirrhotic patient with hepatitis C and alcoholic liver disease.

Abstract

Non-operative management is the management of choice for haemodynamically stable patients with blunt splenic injury. However, coexistent liver cirrhosis poses significant challenges as it leads to portal hypertension and coagulopathy. A 52-year-old man sustained blunt abdominal trauma causing low-grade splenic injury. However, he was found to have liver cirrhosis causing haemodynamic instability requiring emergency laparotomy. His portal hypertension led to severe bleeding only controlled by aortic pressure and subsequent splenectomy. Mortality from emergency surgery in cirrhotic patients is extremely high. Despite aggressive resuscitation, they may soon become haemodynamically unstable. Therefore, traumatic splenectomy may be inevitable in such patients with portal hypertension and splenomegaly secondary to liver cirrhosis even in low-grade injury.

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  • Publisher Full Text
  • Authors

    Matar HE, Elmetwally AS, Nair MS, Borgstein R, Oluwajobi O

    Source

    BMJ case reports 2012: 2012 pg

    MeSH

    Diagnosis, Differential
    Hepatitis C, Chronic
    Humans
    Laparotomy
    Liver Cirrhosis
    Liver Diseases, Alcoholic
    Male
    Middle Aged
    Spleen
    Splenectomy
    Splenic Rupture
    Tomography, X-Ray Computed
    Wounds, Nonpenetrating

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    22665581