Akın ÖNDER, Ömer BAŞOL, Murat KAPAN, Güven TEKBAŞ, Sadullah GİRDİN

Üremik koagülopatiye bağlı spontan dalak rüptürü

Üremik koagülopatili hastalarda spontan dalak rüptürü nadir karşılaşılan, önemli bir klinik antitedir. Travma öyküsü olmadığından, hastalık göz ardı edilebilir veya tanısı gecikebilir. Bu çalışmada sol üst karın ağrısı, hal sizlik ve idrar miktarında azalma şikâyetleriyle nefroloji kliniğine başvuran ve üremi tanısıyla hastaneye yatırılan 77 yaşında erkek hasta sunulmuştur. Gözlem altınday ken karın ağrısının devam etmesi nedeniyle abdominal ultrasonografi çekildi ve dalakta hematom tespit edildi. Kliniğimize sevk edilen hastaya konservatif tedavi uygu landı ve 10. gün şifa ile taburcu edildi.

Anahtar Kelimeler:

Erkek, Yaşlı, Dalak rüptürü, Yırtılma, spontan

Spontaneous splenic rupture due to uremic coagulopathy

Spontaneous splenic rupture is a rare and an important clinical entity in patients with uremic coagulopathy. Due to the absence of trauma history, the diagnosis can be overlooked and delayed. In this paper, we present a 77- year old male patient who was admitted to the nephrology clinic with the complaints of left upper abdominal pain, fatigue and reduction in the amount of urine output. He was diagnosed with uremia. While the patient was under observation, abdominal ultrasonog- raphy was performed due to the continued abdominal pain and a splenic hematoma was detected. The patient was refferred to our clinic and managed with conservative approach and discharged uneventfully at 10th day.

Keywords:

Male, Aged, Splenic Rupture, Rupture, Spontaneous,

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1. Kim HJ, Lee GW, Park DJ, Lee JD, Chang SH. Spontaneous Splenic Rupture in a Hemodialysis Patient. Yonsei Medical Journal 2005;46(3):435-8.
2. Debnath D, Valerio D. Atraumatic rupture of the spleen in adults. J R Coll Surg Edinb 2002;47(1):437-45.
3. Zbrog Z, Pawlicki L. Spontaneous rupture of the spleen as a cause of death of a patient with uremia. Pol Tyg Lek 1989;44(9):232-3.
4. Katsanos KH, Theodorou J, Katopodis KP, Siamoupoulos KC. Spontaneous splenic rupture complicating pancreatitis in a chronic hemodialysis patient. Clin Nephrol 2004;61(6):448-9.
5. Badenoch DF, Maurice HD, Gilmore OJ. Spontaneous rupture of a normal spleen. J R Coll Surg Edinb 1985;30(5):326-7.
6. Acar YA, Dedeoğlu E, Çevik E, Çınar O, Arslan D, Kesim E, et al. Spontaneous Rupture of Spleen as a Rare Cause of Abdominal Pain. Eur J Surg Sci 2010;1:27-9.
7. Zieren J, Paul M, Scharfenberg M, Muller JM. The spontaneous splenic rupture as first manifestation of mantle cell lymphoma, a dangerous rarity. Am J Emerg Med 2004;22(7):629-31.
8. Yağmur Y, Kara İH, Aldemir M, Büyükbayram H, Taçyıldız İH, Keleş C. Spontaneous rupture of malarial spleen: two case reports and review of literature. Crit Care 2000;4(5):309-13.
9. Debnath D, Valerio D. Atraumatic rupture of the spleen in adults. J R Coll Surg Edinb 2002;47(1):43745.
10. Orloff MJ, Peskin GW. Spontaneous rupture of the normal spleen; a surgical enigma. Int Abs Surg 1958;106(1):1-11.
11. Crate ID, Payne MJ. Is the diagnosis of spontaneous rupture of a normal spleen valid? J R Army Med Corps 1991;137(1):50-1.
12. Lazarus JM, Brenner BM. Chronic renal failure. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL. Harrisons Principles of Internal Medicine. 14th ed. USA: The McGraw-Hill 1998: 1513-20.
13. Toubia NT, Tawk MM, Potts RM, Kinasewitz GT. Cough and spontaneous rupture of a normal spleen. Chest 2005;128(3):1884-6.
14. Torricelli P, Coriani C, Marchetti M, Rossi A, Manenti A. Spontaneous rupture of the spleen: report of two cases. Abdom Imaging 2001;26(3): 290-3.
15. Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma 1995;38(3):3234.
16. Peitzman AB, Heil B, Rivera L, Federle MB, Harbrecht BG, Clancy KD, et al. Blunt splenic injury in adults: multi-institutional study of the Eastern Association for the Surgery of Trauma. J Trauma 2000;49(2):17789.
17. Hadary A, Dashkovsky I, Rapaport A, Cozakov JC. Non-traumatic rupture of spleen: can splenectomy be applied selectively? Isr Med Assoc J 2008;10(12):88991.