Spontaneous Splenic Artery Rupture as the First Symptom of Systemic Amyloidosis.

Q3 Medicine

Case Reports in Critical Care Pub Date : 2021-03-08 eCollection Date: 2021-01-01 DOI:10.1155/2021/6676407

Øyvind Bruserud, Tor Henrik Anderson Tvedt, Aymen Bushra Ahmed, Olav Karsten Vintermyr, Tor Hervig, Anne Berit Guttormsen, Håkon Reikvam

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引用次数: 2

Abstract

Spontaneous splenic rupture is a life-threatening condition leading to a rapidly progressing hypovolemic shock due to intra-abdominal blood loss, with a mortality rate of about 10%. Spontaneous splenic rupture can be caused by widely different disorders including acute and chronic infections, neoplastic disorders, and inflammatory noninfectious disorders. In this case report, we present a 67-year-old male patient with hemorrhagic shock caused by an acute bleeding from the splenic artery. The patient was massively transfused with blood products and fluids and underwent laparotomy for hemostatic control and clinical stabilization. Multiorgan involvement by amyloid light-chain amyloidosis (AL-amyloidosis) caused by plasma cell dyscrasia, specifically with infiltration of the spleen artery, was found to be the underlying cause of his life-threatening bleeding. Based on this case, we discuss the features of serious spleen bleeding, massive transfusion therapy in the intensive care setting, and AL-amyloidosis pathophysiology and treatment.

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自发性脾动脉破裂是全身性淀粉样变性的首要症状。

自发性脾破裂是一种危及生命的疾病，由于腹腔内失血导致快速进展的低血容量性休克，死亡率约为10%。自发性脾破裂可由多种疾病引起，包括急性和慢性感染、肿瘤疾病和炎症性非感染性疾病。在这个病例报告中，我们提出了一个67岁的男性患者失血性休克引起的急性出血从脾动脉。患者大量输注血液制品和液体，并进行剖腹手术以止血控制和临床稳定。浆细胞病变引起的淀粉样蛋白轻链淀粉样变性(AL-amyloidosis, AL-amyloidosis)累及多器官，特别是脾动脉浸润，被发现是危及生命的出血的根本原因。在此病例的基础上，我们讨论了严重脾出血的特点、重症监护室大量输血的治疗以及al -淀粉样变的病理生理和治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Case Reports in Critical Care Medicine-Critical Care and Intensive Care Medicine

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

12 weeks