Nontraumatic splenic rupture as the initial manifestation of acute myeloid leukemia in emergency department

• Published in: The American journal of emergency medicine Vol. 34; no. 8; pp. 1731.e1 - 1731.e3
• Main Authors: Aydin, A. Attila, MD, Şenocak, Rahman, MD, Bilge, Sedat, MD, Kaymak, Şahin, MD, Kilbaş, Zafer, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2016; Elsevier Limited
• Subjects: Abdomen; Blood; Emergency; Emergency medical care; Emergency Service, Hospital; Fatal Outcome; Health risks; Hematology; Humans; Infections; Intensive care; Leukemia; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - diagnosis; Male; Medical imaging; Metabolic disorders; Middle Aged; Mortality; Pain; Rupture, Spontaneous; Spleen; Splenic Rupture - diagnostic imaging; Splenic Rupture - etiology; Tomography, X-Ray Computed; Ultrasonic imaging
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2015.12.044

An Extended Focused Assessment with Sonography for Trauma (E-FAST) examination conducted to detect the etiology of hypotension revealed diffuse free fluid and splenomegaly (with a long axis of 154mm) in the abdomen. Because the patient was thought to be in hemorrhagic shock, fluid replacement was administered, and the transfusion of blood products was commenced. Because of the risk of infection following splenectomy, the tendency to select nonoperative treatment is popular in hemodynamically stable patients [7]; however, splenectomy is the main treatment option for adults with leukemia and with pathological splenic rupture.