Successful emergency splenectomy during cardiac arrest due to cytomegalovirus-induced atraumatic splenic rupture.
| Autor: | Glesner MK; Department of Infectious Disease, Odense University Hospital, Odense, Denmark., Madsen KR; Department of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Nielsen JM; Surgical Department A, Odense University Hospital, Odense, Denmark., Posth S; Department of Emergency Medicine, Odense University Hospital, Odense, Denmark. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2015 Mar 26; Vol. 2015. Date of Electronic Publication: 2015 Mar 26. |
| DOI: | 10.1136/bcr-2014-208094 |
| Abstrakt: | A 27-year-old woman was admitted to the emergency department with fever and a petechial rash on suspicion of meningitis. Shortly after arriving she developed cardiac arrest. Blood work up showed severe lactate acidosis, anaemia and thrombocytopenia. A focused assessment with sonography in trauma scan showed free intraperitoneal fluid and an emergency laparotomy revealed massive bleeding from a ruptured spleen. The patient was successfully resuscitated. She proved to be infected with cytomegalovirus causing idiopathic thrombocytopenic purpura, splenomegaly and splenic rupture. She was treated for 14 days with ganciclovir and meropenem and discharged on recovery. Atraumatic splenic rupture caused by viral infection is a rare condition although well described. In the case of our patient, thrombocytopenia added to the severity of the splenic rupture. A multidisciplinary team approach was essential for the management and the eventual recovery of the patient. (2015 BMJ Publishing Group Ltd.) |
| Databáze: | MEDLINE |
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