Journal List > J Korean Surg Soc > v.76(5) > 1010962

Lee, Jang, Hwang, Lim, and Kim: Spontaneous Rupture of Accessory Spleen Detected during Laparoscopic Cholecystectomy

Abstract

Splenic rupture during laparoscopic cholecystectomy is a rare and unusual complication. We report a case of accessory splenic rupture that occurred during laparoscopic cholecystectomy. A 63-year-old male patient underwent laparoscopic cholecystectomy due to acute cholecystitis. After pneumoperitoneum was established, hemoperitoneum was detected. However, a bleeding focus was not found by laparoscopic whole abdominal exploration after laparoscopic cholecystectomy. Twenty-four hours later the patient became hypotensive and laparoscopic reexploration was performed. Hematoma and omental adhesion was detected around accessory spleen. Laparoscopic accessory splenectomy was performed. Distortion or stretching of perisplenic adhesion due to the induction of pneumoperitoneum possibly resulted in sudden splenic rupture and hemoperitoneum.

Figures and Tables

Fig. 1
CT scan showing large stone in the neck of the gallbladder with edematous wall and mild pericholecystic fat infiltration.
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Fig. 2
CT scan showing 8.5 cm sized accessory spleen in the left upper quadrant.
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References

1. Prian DV. Ruptured spleen as a complication of laparoscopy and pelvic laparotomy. Report of an unusual complication. Am J Obstet Gynecol. 1974. 120:983–984.
2. Makanji HH, Elliott HR. Rupture of spleen at laparoscopy. Case report. Br J Obstet Gynaecol. 1980. 87:73–74.
3. Takeuchi K, Yamada T, Sato A, Nakago S, Maruo T. Rupture of the spleen as an unusual complication of laparoscopy. A case report. J Reprod Med. 2001. 46:779–780.
4. Madu AE, Raychaudhuri RK, Khan SU, Ghosh S. Splenic rupture following laparoscopic salpingectomy. J Obstet Gynaecol. 2006. 26:476–477.
5. Leff D, Nortley M, Melly L, Bhutiani RP. Ruptured spleen following laparoscopic cholecystectomy. JSLS. 2007. 11:157–160.
6. Richmond R, Humphrey P, Nichols WK. Isolated traumatic accessory splenic rupture: a case report and literature review. Mo Med. 1992. 89:351–353.
7. Texeira MB, Hardin WJ. Spontaneous rupture of accessory spleen. Am Surg. 1974. 40:491–493.
8. Karam JA, Kozar RA. Solitary blunt rupture of an accessory spleen. J Trauma. 1998. 44:220–221.
9. The Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med. 1991. 324:1073–1078.
10. Bailey RW, Zucker KA, Flowers JL, Scovill WA, Graham SM, Imbembo AL. Laparoscopic cholecystectomy. Experience with 375 consecutive patients. Ann Surg. 1991. 214:531–541.
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