NON-OPERATIVE MANAGEMENT FOR DELAYED RUPTURE OF THE SPLEEN -REPORT OF A CASE-

Abstract

During the past one decade splenic salvage procedures rather than splenectomy have been increasinglyconsidered the preferred treatment for traumatic splenic injurices. A case of delayed rupture of the spleen, which occurred 12 days after intentional non-operative management for the ruptured spleen due to a trauma, is reported with a review of the literature.
A 19-year-old man got a bruise on the abdomen due to a traffic accident. CT and ultrasonography revealed hematoma in the spleen and intraperitoneal bleeding. The patient was diagnosed as splenic rupture and underwent non-operative management by keeping at rest in bed for 11 days. On the 12th day when he was permitted to walk, he suddenly complained of abdominal pain. A delayed rupture of the spleen was diagnosed, and intentional nonoperative management was performed once again. Thereafter, his clinical course was quite uneventful. Forty days after the trauma, he was discharged with two splenic cysts due to the traumatic splenic injury.
In selected cases of delayed rupture of the spleen, non-operative management should be also an acceptable alternative.