Diagnosis and treatment of spleen rupture during pancreatitis

A 31-year old man was admitted for acute pancreatitis. His condition deteri orated progressively and he developed on acute anemia followed five days af ter admission by an hemorrhagic shock consecutive to splenic rupture. A 45- year old woman was admitted because of an acute episode of chronic pancreat itis. She improved progressively but developed eleven days after admission an hemorrhagic shock consecutive to the rupture of a subcapsular haematoma of the spleen. Splenic rupture, on unfrequent complication of acute or chronic pancreatiti s, is responsible for anemia and hemorrhagic shock. Abdominal ultrasonograp hy and CT scan are necessary to make the diagnosis of splenic rupture and t o look for risk factors of splenic rupture, i.e. necrosis in the spleen hil ium, left pancreatic pseudocyst, splenic vein thrombosis, segmental portal hypertension, splenomegaly and intrasplenic collection. When possible, embo lization of the splenic artery can stop bleeding. Splenectomy with distal p ancreatectomy seems to be the appropriate treatment of splenic rupture.