Abstract
Splenic rupture in the neonatal period is a rare condition that can be complicated by hemorrhagic shock. The symptoms are not very specific, rendering the diagnosis difficult and often delayed; sometimes only discovered at autopsy. We report five cases diagnosed in the Rhône-Alpes region of France. From these observations and from a review of the literature, the circumstances of the occurrence, the clinical signs, and the therapeutic possibilities are discussed. In the presence of severe anemia with pallor and abdominal distension, particularly in the context of a difficult birth, an abdominal ultrasound must be urgently performed and surgical management promptly considered.
Conclusion: This pathology must be known to the neonatologist so that she/he can quickly evoke it, given that it can quickly become life-threatening.
What is known: • Splenic rupture in the neonatal period is a rare condition that can be complicated by hemorrhagic shock and quickly lead to the death of the newborn. |
• The symptoms are not very specific, rendering the diagnosis difficult and often delayed. |
What is new: • This is the first publication bringing together as many clinical cases on the subject reporting in particular very serious cases to alert the clinician on this pathology and its diagnostic urgency. • We propose a clear therapeutic behavior to help the clinician in his daily practice. |
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Abbreviations
- DIC:
-
Disseminated intravascular coagulation
- TFU:
-
Transfontanelle ultrasonography
- WA:
-
Weeks of amenorrhea
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Acknowledgements
We thank Dr. Alison Foote (Grenoble-Alps University Hospital) for translating the manuscript.
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Claire-Sophie Descamps wrote the entire article, performed the litterature review and coordinated the review of all co authors.
Dr. Fabrice Cneude helped to retrieve the data from a case. He also helped in the writing of the manuscript.
Dr. Stephane Hays helped to find two cases for this report and to retrieve the data from cases. He also helped in the writing of the manuscript.
Dr. Isabelle Rayet helped to find one case for this report and to retrieve the data from this case.
Pr. Christian Piolat helped in the redaction of the discussion of the manuscript.
Dr. Chloé Epiard helped in the correction and the writing of the manuscript.
Pr. Thierry Debillon helped in the correction and the writing of the manuscript.
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The authors declare that they have no conflict of interest.
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This article does not contain any studies with human participants or animals performed by any of the authors.
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Communicated by Patrick Van Reempts
Revisions received: 13 June 2017 / 10 July 2017
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Descamps, CS., Cneude, F., Hays, S. et al. Early hypovolemic shock and abdominal distention due to neonatal splenic rupture: urgency of diagnosis and management. Eur J Pediatr 176, 1245–1250 (2017). https://doi.org/10.1007/s00431-017-2968-y
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DOI: https://doi.org/10.1007/s00431-017-2968-y