A Case of Delayed Splenic Rupture

Abstract

We report herein on a case of delayed splenic rupture. A 17-year-old man was transferred to our hospital with trauma following a traffic accident. Computed tomography (CT) revealed a splenic injury (TypeⅠb according to the classification of splenic injury by the Japanese Association for the Surgery of Trauma) and left ilium fracture. Since his vital signs were stable, the patient had been treated conservatively and remained event-free. However, he complained of left lower abdominal pain on the 3rd day of hospitalization. CT scan revealed a rupture of the spleen and hemoperitoneum. Transcatheter arterial embolization (TAE) was performed, but as the hemorrhage could not be controlled, an emergency laparotomy and splenectomy were performed. The postoperative course was uneventful and the patient was discharged on the 22nd postoperative day. Because conservative therapy is insufficient in some cases, including TAE like this case, preparations for emergency surgery must be always considered.