A Case of Non-Traumatic Splenic Rupture which might Occur due to Chronic Alcoholic Pancreatitis in the Background

Abstract

Non-traumatic rupture of the spleen is a rare condition, and several cases complicated with alcoholic chronic pancreatitis have been reported to date. A forty-year-old man who drank a bottle of whisky every day felt severe back pain and visited Akita City Hospital. An abdominal CT scan showed rupture of the spleen and extravasation of the contrast media, hematoma with an amount of bloody ascites, and a pancreatic cyst. Subsequently, he underwent abdominal angiography but transcatheter arterial embolization was not done because of the lack of extravasation at that time. We upgraded the patient’s general condition with a blood transfusion and his anemia was improved, so on the next morning, he underwent a laparotomy. There was a subcapsular hematoma mimicking rupture of the spleen, and he underwent a splenectomy. He developed alcohol withdrawal a couple of days after surgery, and an intra-abdominal abscess was noted adjacent to the pancreatic tail, which decreased with antibiotic therapy. He was discharged from the hospital on postoperative day 18.