Rare Case of Spontaneous Splenic Hematoma Following Chronic Pancreatitis- A Case Report
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 2
Abstract
Spontaneous splenic hematoma is a rare complication of acute or chronic pancreatitis when compared with traumatic origin of subcapsular hematoma. Local factors such as thrombosis of the splenic artery or veins, intrasplenicpseudocysts, perisplenic adhesions, enzymatic digestion and coagulation disorders may play a role in the pathogenesis of splenic hematoma. Here we report a case of a 57 years old gentleman who presented to Emergency Department with complains of severe pain and mass in the left upper abdomen for the past 2 weeks. On examination he was haemodynamically stable, with a palpable mass in the left hypochondrium. On blood investigation serum amylase and lipase were significantly raised. His Hb was 7gm%. CECT of abdomen revealed features of chronic pancreatitis and large subcapsular splenic haematoma 17x12cm in size. He was managed with intravenous fluid, blood transfusions, prophylactic antibiotic and pain killers. Patient responded well to the conservative management. His blood parameters improved and splenic haematoma showed gradual resolution on serial USG examination. The management of subcapsular splenic hematoma in pancreatitis is not established. Treatment option includes conservative management, splenectomy and percutaneous drainage. Some authors suggested that most splenic complications of pancreatitis regress spontaneously and may be managed conservatively. It is suggested that conservative approach to the management of splenic subcapsular hematoma is appropriate when the patient is haemodynamically stable and is showing improving signs and symptoms.
Authors and Affiliations
Dr. Sreejith V, Dr. Gamelial Kharshing, Dr. Lingaraju, Dr. Piyush Agarwal, Prof G S Moirangthem
Keywords
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- EP ID EP580450
- DOI 10.9790/0853-1702054547.
- Views 88
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