DOI: http://dx.doi.org/10.18203/2349-2902.isj20213616

Spontaneous splenic rupture in a patient with chronic granulocytic leukemia

Hector Vergara Miranda, Raúl Omar Martínez Zarazúa, Mayra Alexandra Hernandez Ramírez, José Angel Rodríguez Briseño, Gerardo Enrique Muñoz Maldonado

Abstract


Spontaneous splenic rupture is a rare phenomenon that is not associated with trauma. The most common causes of splenic rupture are hematological diseases (30.3%), inflammatory diseases (20%), infectious diseases (27.3%), drugs (9.2%), mechanical disorders (6.8%), and unknown causes (6.4%). Spontaneous splenic rupture secondary to hematological malignancy is rare; in this group of patients, chronic granulocytic leukemia is the main cause. The mechanism of spontaneous splenic rupture is uncertain. Three mechanisms have been suggested: the mechanical effect of leukemia and its infiltration in the spleen, especially if the capsule is invaded; splenic infarction with subsequent subcapsular hemorrhage and rupture of the splenic capsule, and coagulation abnormalities.


Keywords


Spontaneous splenic rupture, Hematological malignancy, Emergency splenectomy

Full Text:

PDF

References


Tessely H, Journe S, Katz R, Lemaitre J. Case report of a spontaneous splenic rupture in a patient with chronic lymphocytic leukaemia treated by arterial splenic embolization. Int J Surg Case Rep. 2021;80: 105607.

Rueda-Esteban R, Stozitzky Muñoz N, Barrios Díaz M, García Sierra A, Perdomo CF. Spontaneous splenic rupture in a patient with chronic myeloid leukemia: A case report. Int J Surg Case Rep. 2020;66: 122-125.

Mourato Nunes I, Pedroso AI, Carvalho R, Ramos A. Chronic lymphocytic leukaemia and spontaneous rupture of spleen. BMJ Case Rep. 2018;2018: bcr2017221692.

Giagounidis AA, Burk M, Meckenstock G, Koch AJ, Schneider W. Pathologic rupture of the spleen in hematologic malignancies: two additional cases. Ann Hematol. 1996;73(6):297-302.

Abbasi AM, Adil S, Moiz B. Spontaneous splenic rupture-An uncommon complication of chronic myelomonocytic leukemia. Leuk Res Rep. 2020;14: 100205.

Biswas S, Keddington J, McClanathan J. Large B-cell lymphoma presenting as acute abdominal pain and spontaneous splenic rupture; a case report and review of relevant literature. World J Emerg Surg. 2006;1:35.

Roll GR, Lee AY, Royaie K, et al. Acquired A amyloidosis from injection drug use presenting with atraumatic splenic rupture in a hospitalized patient: a case report. J Med Case Rep. 2011;5:29.

Amaki J, Sekiguchi T, Hiraiwa S, Kajiwara H, Kawai H, Ichiki A, Nakamura N, Ando K. Three cases of spontaneous splenic rupture in malignant lymphoma. Int J Hematol. 2018;108(6):647-51.

Weaver H, Kumar V, Spencer K, Maatouk M, Malik S. Spontaneous splenic rupture: A rare life-threatening condition; Diagnosed early and managed successfully. Am J Case Rep. 2013;14:13-5.

Forghieri F, Morselli M, Leonardi G, Potenza L, Bonacorsi G, Coluccio V, et al. Atraumatic splenic rupture in patients with myelodysplastic syndromes: report of a case occurred during treatment with 5-azacitidine and review of the literature. Leuk Res. 2012;36(3):e52-6.

Jain D, Lee B, Rajala M. Atraumatic Splenic Hemorrhage as a Rare Complication of Pancreatitis: Case Report and Literature Review. Clin Endosc. 2020;53(3):311-20.

Kuba A, Szotkowski T, Rohon P, Faber E, Turcsanyi P, Hubacek J, et al. Spontaneous splenic rupture in a patient with acute promyelocytic leukaemia during induction chemotherapy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(2):294-8.

Spapen J, Fostier K, De Raeve H, Janssens P, Spapen H. An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration. Int J Nephrol Renovasc Dis. 2015;9:1-4.