2002, Number 1
Spontaneous rupture of the spleen associated to a small-elements splenic lymphangioma. Report on one patient
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ABSTRACTObjective: To report a case of small-elements splenic lymphangioma associated with hemorrhage in a young woman.
Setting: Third level health care hospital.
Description of the case: Twenty-five years old woman, she was admitted to the hospital after 14 hours of oppressive abdominal pain in the hypograstrium and left iliac fossa accompanied by nausea, gastric content vomiting, dizziness, and diaphoresis, with a 6-weeks menstruating delay. Vital signs were: arterial blood pressure of 110/70 mmHg, cardiac frequency of 80 beats/min, and respiratory frequency of 18/min. Physical exploration revealed slight tegmental pallor. Abdomen was painful to palpation, with muscular resistance and rebound hypersensitivity in the hypogastrium and iliac fosse, intestinal noises were diminished in intensity and frequency, with slight flat sounds in the inferior hemiabdomen. Genital exploration, using an intrauterine guiding device through the external orifice, revealed an elastic, moist, and normothermal vagina; the uterine neck in central position, formed, soft and closed. Laboratory tests at admittance reported 10.2 g/dl hemoglobin, 8,700 leukocytes, 164,000/mm3 platelets, normal coagulation time and blood chemistry values. The abdominal ultrasound revealed free liquid and uterine myomatosis. Exploratory laparotomy was performed. During surgery, the uterus showed myomas and normal annexes. A hemoperitoneum of approximately 2000 ml was found, the spleen was normally sized, with cysts at the hilium, and active hemorrhage; splenectomy was performed. No complications occurred during the postoperative period and the patient was released three days after surgery.
Conclusion: We present a case of small-elements splenic lymphangioma associated with hemorrhage in a young woman, which was resolved through surgery.
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