Abstract
A 30-year-old man was admitted to our hospital because of left upper abdominal pain and left shoulder pain. One month prior, he had hurt his left lateral chest and abdomen when he fell on the ground ; however, he had not visited a hospital. Abdominal computed tomography (CT) scan on admission showed ascites throughout the abdomen, but neither injuries nor tumors of any abdominal organs were observed. Fresh blood was aspirated by abdominal paracentesis. Two days after admission, diagnostic laparotomy was performed because the abdominal pain had increased and spread. Laparoscopic findings indicated bleeding from the spleen ; therefore, a splenectomy was performed by opening the abdomen. Two parenchymal injuries were macroscopically observed on the spleen. Pathological findings did not show malignancies but only congestion and edema of the spleen ; neither malignant lymphoma nor leukemia were found on hematological examination. On the basis of these findings and the history of injury, the patient was diagnosed as having delayed splenic rupture. We report a rare case of delayed splenic rupture 1 month after injury. Despite the difficulty in making the preoperative diagnosis, diagnostic laparoscopy was very useful in this case.
