A Case of Intrasplenic Pseudoaneurysm With Delayed Splenic Rupture Occurring Twelve Days After Injury

Abstract

A 66-year-old woman fell down the stairs and visited our hospital. Radiography revealed fractures in the right humerus and the 7th-9th left ribs；thus, she was admitted to the Department of Orthopedic Surgery. Surgery for the humerus fracture was performed on the 11th hospital day. On the 12th hospital day, the patient's blood pressure decreased suddenly, and a laboratory examination showed the progression of anemia. An abdominal computed tomography (CT) examination revealed a hematoma around the spleen and the extravasation of contrast medium into the intraperitoneal space. We also identified a delayed splenic rupture with hemorrhagic shock. We confirmed the bleeding point of the distal splenic artery using angiography and performed a transcatheter angiographic embolization. When the course of this case was reviewed, the abdominal CT findings obtained on the 3rd hospital day revealed an intrasplenic pseudoaneurysm that might have led to the delayed splenic rupture.