Journal of Emergency Practice and Trauma

Splenic injury in pregnancy requiring urgent splenectomy: A rare surgical emergency

Document Type : Case Report

Authors

Daniel AA Umezurike 1, 2
Aloysius Ugwu-Olisa Ogbuanya 3
Bieda Fongue Jean Robert 4
Ifeoma Cecilia Ekwunife 5

1 1Department of Surgery, General Surgery Center, College of Medical Sciences, Alex Ekwueme Federal University Teaching Hospital, Ebonyi State, Nigeria

2 2Department of Surgery, General Surgery Center, College of Health Sciences, Ebonyi State University, Ebonyi State, Nigeria

3 1Department of Surgery, General Surgery Center, College of Medical Sciences, Alex Ekwueme Federal University Teaching Hospital, Ebonyi State, Nigeria 2Department of Surgery, General Surgery Center, College of Health Sciences, Ebonyi State University, Ebonyi State, Nigeria 3Department of Surgery, General Surgery Center, College of Medical Sciences, Alex Ekwueme Federal University, Ebonyi State, Nigeria

4 Department of Surgery, General Surgery Center, College of Medical Sciences, Alex Ekwueme Federal University Teaching Hospital, Ebonyi State, Nigeria

5 Department of Obstetrics and Gynecology, Obstetrics Emergency Center, College of Medical Sciences, Alex Ekwueme Federal University Teaching Hospital, Ebonyi State, Nigeria

https://doi.org/10.34172/jept.2024.08
Abstract
Objective: The spleen is the most frequently injured organ in blunt abdominal trauma (BAT). We present an interesting case of traumatic splenic rupture in pregnancy managed successfully by emergency splenectomy in a low-resource setting.
Case Presentation: A 27-year old multiparous woman at 23 weeks gestational age presented to the emergency department with a history of BAT following a road traffic accident (RTA). This study was conducted in the Department of Surgery, General Surgery Unit, College of Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi State, Southeast Nigeria, in 2023. A vehicle strayed and hit her from the left side of the abdomen while she was sitting down. She suddenly developed abdominal pain, bruises on the left upper abdomen, and
progressive abdominal distension. The abdominal ultrasound report showed a deep trabecular laceration and massive hemoperitoneum. The fetus was viable from obstetric and ultrasound assessments. The patient was hemodynamically unstable and was subsequently prepared for emergency exploratory laparotomy. Intraoperatively, incomplete hilar avulsion injury and multiple parenchymal lacerations of the spleen were noted. An accessory spleen without injury was also noted. Splenectomy with preservation of the accessory spleen was performed.
Postoperatively, the fetus remained viable, and the patient was hemodynamically stable. The mother had no morbidities other than paralytic ileus and fever, and both were amenable to conservative management.
Conclusion: Emergency splenectomy is a life-saving procedure in hemodynamically unstable patients with splenic trauma, even in pregnancy.

Keywords

Abdomen
Emergency laparotomy
Pregnancy
Trauma
Splenectomy
Subjects
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Journal of Emergency Practice and Trauma
Volume 10, Issue 1
January 2024
Pages 65-69

  • Receive Date 03 November 2023
  • Revise Date 07 February 2024
  • Accept Date 15 February 2024

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