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Case Reports
. 2017 Mar 22;2017(3):rjx054.
doi: 10.1093/jscr/rjx054. eCollection 2017 Mar.

Cocaine-induced splenic rupture

Aysha N Khan  1 , Jesse T Casaubon  2 , John Paul Regan  2 , Leonora Monroe  2
Affiliations
Case Reports

Cocaine-induced splenic rupture

Aysha N Khan et al. J Surg Case Rep. .

Abstract

Splenic rupture is a rare but serious complication from cocaine abuse. Given the ubiquitous prevalence of abuse and the potential for death from intraperitoneal bleeding, the prompt diagnosis and treatment of cocaine-induced disease including splenic rupture is essential. The management for splenic rupture from traumatic and atraumatic etiology has shifted from emergent laparotomy and splenectomy to non-operative approach with transcatheter splenic artery embolization. We report a 39-year-old male with a significant substance abuse history who presented with atraumatic splenic rupture. He was managed nonoperatively with adjunctive transcatheter splenic artery embolization. His post-procedure course was complicated by an intra-abdominal abscess requiring drainage via interventional radiology guided pigtail catheter placement and intravenous antibiotics. This case report is intended to raise awareness of the potentiating effects of cocaine use in this patient population and highlight questions raised during this patient's management.

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Figures

Figure 1:
Figure 1:
Initial computed tomography of the abdomen and pelvis.
Figure 2:
Figure 2:
Splenic artery angiogram after placement of embolization coil showing patency of flow, no active extravasation.
Figure 3:
Figure 3:
The ‘Islands’ of preserved spleen lit up with IV contrast surrounded by a large collection of old blood and devitalized tissue.
Figure 4:
Figure 4:
3D reconstruction and coronal CT after placement of pigtail drainage catheter.
See this image and copyright information in PMC

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