Citation

Alqtishat B, Hodali A, Abukeshek T, Al-Shobaki T. Int. J. Surg. Case Rep. 2023; 109: e108474.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.ijscr.2023.108474

PMID

37437328

Abstract

INTRODUCTION: Hemodynamic instability in previously stable trauma patients carries rather not a wide differential diagnosis. Delayed Splenic Rupture is certainly not on the top of the list. CASE PRESENTATION: We present a patient with delayed splenic rupture eight days after a blunt abdominal trauma caused by a motor vehicle accident. The patient's initial full-body trauma protocol CT scan was negative for internal injuries and rib fractures. He was discharged after 48 h of uneventful observation. Returning eight days with grade III subcapsular splenic hematoma; with negative history of strenuous activities or a second trauma. A trial of non-operative management was opted for after stabilizing the patient. However, the patient's hemodynamic status deteriorated and he was operated on a couple of hours after presentation.

DISCUSSION: Delayed splenic rupture remains a rare diagnosis with an open time window for presentation. While it is a rare entity, delayed splenic rupture increases the mortality rate in an otherwise non-mortal injury.

CONCLUSION: This case presents an important educational value in bringing forth such rare diagnoses in trauma patients and highlights the management transition from a non-operative approach to an operative one.

Language: en

Keywords

Abdominal trauma; Case report; Delayed splenic rupture; Hemodynamic status; Motor vehicle accident