Antikoagülan tedaviye bağlı spontan splenik hematom: Olgu sunumu

Splenik yaralanma normalde travma ile ilişkilidir, ancak çeşitli sistemik hastalıklarda spontan splenik rüptürü tanımlanmıştır. 46 yaşında erkek hasta acil servise epigastrik ağrı ve sol üst kadranda hassasiyet ile başvurdu. Travma öyküsü yoktu, oral antikoagulan kullanımı mevcuttu. Kontrastlı bilgisayarlı tomografi görüntülemesi dalağın büyük bir subkapsüler hematomunu ortaya çıkardı. Oral antikoagülasyon K vitamini ile antagonize edildi ve hasta 3 günlük klinik gözlemden sonra iyi durumda taburcu edildi. Travmatik olmayan splenik rüptür, oral antikoagülasyonun nadir görülen bir komplikasyonudur.

Spontaneous splenic hematoma due to anticoagulant treatment: A case report

Splenic injury is mostly associated with trauma, but spontaneous splenic injury has been associated in various systemic diseases. A 46-year-old male patient was admitted to the emergency department with epigastric pain and tenderness in the left upper quadrant. There was no history of trauma, but he was using oral anticoagulant treatment. Contrast-enhanced computed tomography imaging revealed a subcapsular hematoma of the spleen. Oral anticoagulation was antagonized with vitamin K and the patient was discharged in good condition after 3 days of clinical observation. Non-traumatic splenic rupture is a rare complication of oral anticoagulation.

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  • 1. Vallabhaneni S, Scott H, Carter J, Treseler P, Machtinger EL. Atraumatic splenic rupture: an unusual manifestation of acute HIV infection. AIDS Patient Care STDS. 2011;25:461-4.
  • 2. Orloff MJ, Peskin GW. Spontaneous rupture of the normal spleen, a surgical enigma. Int Abstr Surg. 1958;106:1-11.
  • 3. Renzulli P, Hostettler A, Schoepfer AM, Gloor B, Candinas D. Systematic review of atraumatic splenic rupture. Br J Surg. 2009;96:1114-21.
  • 4. Gedik E, Girgin S, Aldemir M, Keles C, Tuncer MC, Aktas A. Non-traumatic splenic rupture: report of seven cases and review of the literature. World J Gastroenterol. 2008;14:6711-6.
  • 5. Ozsoy MF, Oncul O, Pekkafali Z, Pahsa A, Yenen OS. Splenic complications in malaria: report of two cases from Turkey. J Med Microbiol. 2004;53:1255-8.
  • 6. Jimenez BC, Navarro M, Huerga H, Lopez-Velez R. Spontaneous splenic rupture due to Plasmodium vivax in a traveler: case report and review. J Travel Med. 2007;14:188-91.
  • 7. Çelikbaş AK, Ergönül Ö, Baykam N, Eren Ş, Güven T, Dokuzoguz B. Türkiye’de sıtma ve 14 yıllık klinik deneyimimiz. Mikrobiyoloji Bülteni. 2006:40:237-43.
  • 8. Toubia NT, Tawk MM, Potts RM, Kinasewitz GT. Cough and spontaneous rupture of a normal spleen. Chest. 2005;128:1884-6.
  • 9. Çalışkan YK, Kınacı E, Dinçel O, Kaygusuz A. Case Report: Nontravmatic Spontaneus Splenic Rupture. IMJ 2007;8(2):27-9.
  • 10. Topçu A, Başak F. Splenic trauma in a patient with portal hypertension and splenomegaly: A case report. J Surg Med. 2017;1(2):38-9.