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Case Reports
. 2012 Jan;5(1):100-2.
doi: 10.4103/0974-2700.93100.

Hemoperitoneum from splenic rupture in an expatriate

Massimo Tonolini  1 , Roberto Bianco
Affiliations
Case Reports

Hemoperitoneum from splenic rupture in an expatriate

Massimo Tonolini et al. J Emerg Trauma Shock. 2012 Jan.

Abstract

Splenic rupture with hemoperitoneum represents a life-threatening surgical emergency. Malaria should be highly suspected as the probable underlying disease in returning travellers, expatriates, or recent immigrants from endemic countries. Malarial complications involving the spleen occur even with appropriate prophylaxis or during antimalarial therapy. Among them, splenic infarction has a favourable course and is treated conservatively, whereas life-threatening rupture requires immediate or delayed splenectomy. Computed tomography (CT) allows confident differentiation between these two complications by identifying ruptured spleen with clotted hematoma and associated high-density peritoneal effusion; furthermore, CT allows differential diagnosis from other causes of spontaneous hemoperitoneum.

Keywords: Malaria; hemoperitoneum; plasmodium falciparum; splenic rupture.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Axial unenhanced (a) and contrast-enhanced (b) images of the upper abdomen reveal splenomegaly with stratified subcapsular and perisplenic hyperdensity consistent with ruptured splenomegaly and clotted hemorrhage. Axial unenhanced image of the pelvis (c) and post-contrast panoramic coronal-reformatted image (d) show moderately hyperdense (30-40 HU) effusion (asterisks) occupying the Douglas pouch as well as other peritoneal compartments
See this image and copyright information in PMC

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