A Rare Case of Ruptured Splenic Pseudocyst

Abstract

A 71-year-old man with a back bruise had been diagnosed with splenic rupture 20 years earlier, but no surgery or interventional radiological therapy was done at that time. He experienced no severe trauma. He had taken an anticoagulant drug, aspirin, for atrial fibrillation since 1999. He suffered cerebral infarction in January 2002. On July 4, 2002, the splenic cyst was detected by CT and he was admitted a week later for upper left abdominal pain and shock. We diagnosed spontaneous rupture of the splenic cyst and hemoperitoneum, which necessitated emergency surgery. We found a large amount of clotted blood and bloody ascites in the peritoneal cavity and a splenic cyst and severe adhesion around the spleen. Histological findings showed posttraumatic changes and splenic infarction containing both relatively new and old necrosis with bleeding. In this case, splenic infarction appeared to be the primary cause of splenic rupture, which may also have been affected by posttraumatic changes and the anticoagulant drug.