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Spleen Non-traumatic Acute Surgical Conditions

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Textbook of Emergency General Surgery
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Abstract

Background: Nontraumatic splenic acute surgical conditions are rare and challenging conditions for the acute care surgeon. The present chapter will provide an overview on splenic abscesses and nontraumatic splenic ruptures.

Results: Splenic abscesses are uncommon and often affect immunocompromised patients; their mortality is relatively high (up to 80%) in immunocompromised patients. The treatment should be tailored on the basis of patients condition, characteristics, and etiology of the abscess and it ranges from nonoperative treatment with broad-spectrum antibiotics to splenectomy.

Nontraumatic spleen rupture is also very uncommon: It is due to the presence of splenomegaly and/or the presence of pathologic spleen tissue. Clinical presentation can range from hemorrhagic shock to unspecific symptoms that make very difficult the diagnosis. Nonoperative management should be reserved to low-grade injuries in presence of stable hemodynamics; splenectomy is the treatment of choice in case of high-grade injuries and hemodynamic instability.

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References

  1. Lee WS, Choi ST, Kim KK. Splenic abscess: a single institution study and review of the literature. Yonsei Med J. 2011;52(2):288–92.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lee MC, Lee CM. Splenic abscess: an uncommon entity with potentially life-threatening evolution. Can J Infect Dis Med Microbiol. 2018;2018:8610657. https://doi.org/10.1155/2018/8610657.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Yilmaz M, Arslan F, Başkan Ö, Mert A. Splenic abscess due to brucellosis: a case report and a review of the literature. Int J Infect Dis. 2014;20:68–70. https://doi.org/10.1016/j.ijid.2013.11.010.

    Article  PubMed  Google Scholar 

  4. Liu YH, Liu CP, Lee CM. Splenic abscesses at a tertiary medical center in northern Taiwan. J Microbiol Immunol Infect. 2014;47(2):104–8. https://doi.org/10.1016/j.jmii.2012.08.027.

    Article  PubMed  Google Scholar 

  5. Tonolini M, Bianco R. Nontraumatic splenic emergencies: cross-sectional imaging findings and triage. Emerg Radiol. 2013;20(4):323–32.

    Article  PubMed  Google Scholar 

  6. Nieciecki M, Kożuch M, Czarniecki M, et al. How to diagnose splenic abscesses? Acta Gastroenterol Belg. 2019;82:421–6.

    CAS  PubMed  Google Scholar 

  7. Divyashree S, Gupta N. Splenic abscess in immunocompetent patients managed primarily without splenectomy: a series of 7 cases. Perm J. 2017;21:16–139. https://doi.org/10.7812/TPP/16-139.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Carbonell AM, Kercher KW, Matthews BD, et al. Laparoscopic splenectomy for splenic abscess. Surg Laparosc Endosc Percutaneous Tech. 2004;14(5):289–91. https://doi.org/10.1097/00129689-200410000-00013.

    Article  Google Scholar 

  9. Gelmini R, Romano F, Quaranta N, et al. Sutureless and stapleless laparoscopic splenectomy using radiofrequency: LigaSure device. Surg Endosc Other Interv Tech. 2006;20(6):991–4. https://doi.org/10.1007/s00464-005-0470-5.

    Article  CAS  Google Scholar 

  10. Renzulli P, Hostettler A, Schoepfer AM, et al. Systematic review of atraumatic splenic rupture. Br J Surg. 2009;96:1114–21. https://doi.org/10.1002/bjs.6737.

    Article  CAS  PubMed  Google Scholar 

  11. Odalović B, Jovanović MD, Stolić R, et al. Spontaneous splenic rupture in infectious mononucleosis. Srp Arh Celok Lek. 2018;146:320–2. https://doi.org/10.2298/SARH160629207O.

    Article  Google Scholar 

  12. Imbert P, Rapp C, Buffet PA. Pathological rupture of the spleen in malaria: analysis of 55 cases (1958–2008). Travel Med Infect Dis. 2009;7:147–59. https://doi.org/10.1016/j.tmaid.2009.01.002.

    Article  PubMed  Google Scholar 

  13. Moore EE, Cogbill TH, Jurkovich GJ, et al. Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995;38(3):323–4.

    Article  CAS  PubMed  Google Scholar 

  14. Coccolini F, Fugazzola P, Morganti L, et al. The World Society of Emergency Surgery (WSES) spleen trauma classification: a useful tool in the management of splenic trauma. World J Emerg Surg. 2019;14:30. https://doi.org/10.1186/s13017-019-0246-1.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Coccolini F, Montori G, Catena F, et al. Splenic trauma: WSES classification and guidelines for adult and pediatric patients. World J Emerg Surg. 2017;12:40. https://doi.org/10.1186/s13017-017-0151-4.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Renzulli P, Gross T, Schnüriger B, et al. Management of blunt injuries to the spleen. Br J Surg. 2010;97:1696–703. https://doi.org/10.1002/bjs.7203.

    Article  CAS  PubMed  Google Scholar 

  17. Coco D, Leanza S. Indications for surgery in non-traumatic spleen disease. Open Access Maced J Med Sci. 2019;7:2958–60. https://doi.org/10.3889/oamjms.2019.568.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tahir F, Ahmed J, Malik F. Post-splenectomy sepsis: a review of the literature. Cureus. 2020;12:e6898. https://doi.org/10.7759/cureus.6898.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bonanni P, Grazzini M, Niccolai G, et al. Recommended vaccinations for asplenic and hyposplenic adult patients. Hum Vaccin Immunother. 2017;13(2):359–68.

    Article  PubMed  Google Scholar 

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Ceresoli, M., Degrate, L. (2023). Spleen Non-traumatic Acute Surgical Conditions. In: Coccolini, F., Catena, F. (eds) Textbook of Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-22599-4_62

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  • DOI: https://doi.org/10.1007/978-3-031-22599-4_62

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-22598-7

  • Online ISBN: 978-3-031-22599-4

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