Abstract
We encountered a 12-year-old boy with chronic myelogenous leukemia (CML) who developed delayed hemorrhagic shock due to traumatic splenic rupture. He visited a local doctor because of persistent pain in the left hypochondrial region after slight abdominal trauma. At that time, imaging studies revealed subcapsular hemorrhage of the spleen, and he was transferred to our hospital. Blood and bone marrow examination on admission suggested a diagnosis of CML at the chronic phase. Although the patient was managed by conservative treatment, he acutely showed oliguria, a decrease of blood pressure, and an increase of heart rate 42 hours after the injury. Emergent splenectomy was performed under the diagnosis of delayed intraperitoneal hemorrhage due to splenic rupture. The patient recovered after a favorable postoperative course without any complications. After treatment with hydroxyurea and interferon α, he received an allogeneic marrow graft from his sister and is now in complete remission. Clinical reports of CML with splenic rupture are sparse. Since previous reports are of spontaneous cases, our present case of splenic rupture caused by trauma can be considered as a rare one.
