Year 2022 Vol. 30 No 2

CASE REPORTS

A.V. MALOSHTAN, A. A. NEKLIUDOV, V. Y. BROVKIN

SPONTANEOUS SPLENIC RUPTURE AS A FIRST MANIFESTATION OF CHRONIC MYELOLEUKEMIA

V. T. Zaytsev Institute of General and Urgent Surgery,
National Academy of Medical Sciences of Ukraine, Kharkiv,
Ukraine

Spontaneous rupture of the spleen is a rare incident and occurs without visible external mechanical injury. However, the mortality rate is 2-5 folds higher than that of a traumatic rupture, which is usually associated with the underlying disease. In most of these pathological conditions, proliferative processes within the organ, vascular thrombosis, heart attacks and hematomas cause a rapid enlargement of the spleen volume measured by size. At some stage, this volume begins to exceed the permissible volume of the organ, limited by the stretch limit of its capsule. Then breakup occurs.
Two observations are of great interest in the sense of spontaneous rupture of the spleen with massive bleeding (III degree) occurred against the background of complete well-being and was the first symptom of a neglected proliferative blood disease. Before the spontaneous rupture, both patients had no complaints about the general condition of the body and led an active lifestyle. One rupture occurred during diagnostic performance of a contrast-enhanced CT-scan. It was diagnosed not only violation of the integrity of the organ, but also ongoing intra-abdominal arteriovenous bleeding. The second rupture occurred during sleep, when any, even the most insignificant, mechanical injury is completely ruled out. Timely diagnosis and surgical treatments (splenectomy and hemostasis) have prevented the adverse outcomes.

Keywords: spleen, spontaneous rupture, splenectomy, myeloleukemia, blood transfusion
p. 221-227 of the original issue
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Address for correspondence:
61103, Ukraine, Kharkiv, Balakirev Entry, 1
V. T. Zaytsev Institute
of General and Urgent Surgery,
the Department of the Liver
and Biliary Ducts, Surgery,
tel. +380 573 49-41-20,
e-mail: andrey.aleksandrovich@googlemail.com,
Nekliudov Andrey A.
Information about the authors:
Maloshtan Aleksandr V., MD, Chief Researcher, “National Academy of Medical Sciences of Ukraine, V. T. Zaytsev Institute of General and Urgent Surgery”, Kharkiv, Ukraine
https://orcid.org/0000-0001-5205-8480
Nekliudov Andrey A., PhD, Researcher, “National Academy of Medical Sciences of Ukraine, V. T. Zaytsev Institute of General and Urgent Surgery”, Kharkiv, Ukraine
https://orcid.org/0000-0001-5567-2419
Brovkin Viacheslav Y., Junior Researcher, “National Academy of Medical Sciences of Ukraine, V. T. Zaytsev Institute of General and Urgent Surgery”, Kharkiv, Ukraine
https://orcid.org/0000-0003-4684-9096
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