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Case Reports
. 1996 Apr;39(2):151-4.

Delayed rupture of the spleen and streptokinase therapy

R Nam  1 , M M Carr, C G Jamieson
Affiliations
Case Reports

Delayed rupture of the spleen and streptokinase therapy

R Nam et al. Can J Surg. 1996 Apr.

Abstract
in English, French

Delayed rupture of the spleen is a rare but serious complication of blunt abdominal trauma. A 47-year-old woman with a history of fractured pelvis from a motor vehicle accident 6 months earlier presented with evidence of a myocardial infarction. Subsequent streptokinase administration was complicated by splenic rupture, which was managed by evacuation of the clotted blood and splenectomy. The patient made a complete recovery. The risk of splenic rupture and bleeding complications resulting from thrombolytic therapy for myocardial infarction is discussed, as are the controversy over whether delayed splenic rupture is a true diagnosis, the mechanism of rupture and the clues to impending rupture.

Une rupture retardée de la rate constitue une complication rare mais grave d’une contusion de l’abdomen. Une femme de 47 ans qui avait subi une fracture du bassin dans un accident de la circulation 6 mois plus tôt se présente avec des signes d’infarctus du myocarde. L’administration subséquente de streptrokinase a été compliquée par une rupture de la rate, qui a été traitée par évacuation du sang coagulé et une splénectomie. La patiente s’est rétablie complètement. On discute du risque de rupture de la rate et de complications par saignement à la suite d’une thérapie thrombolytique contre un infarctus du myocarde, de la controverse suscitée par la question de savoir si une rupture retardée de la rate constitue un véritable diagnostic, ainsi que du mécanisme de rupture et des signes de rupture imminente.

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