alexa Spontaneous Intra-abdominal Haemorrhage From Peri-splenic Vessels In An Atraumatic Patient: A Case Report
ISSN: 2161-1076

Surgery: Current Research
Open Access

Like us on:
OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

6th International Conference and Exhibition on Anesthesia and Surgery
September 07-09, 2017 | London, UK

Theadora Forster-Anderson and Rita Poon
Fiona Stanley Hospital, Australia
Royal Australasian College of Surgeons, Australia
Posters & Accepted Abstracts: Surgery Curr Res
DOI: 10.4172/2161-1076-C1-033
Abstract
Introduction: Atraumatic splenic and peri-splenic haemorrhage accounts for 1/5 splenic bleed. Those without intra-capsular haemorrhage are less common and not widely documented. When bleeds occur without trauma, it tends to be in the presence of portal hypertension from liver cirrhosis, haematological malignancy, infection, primary hepatoma, pancreatitis, pregnancy or amyloidosis. Case: A 72-year-old presented with acute epigastric pain, tachycardia, hypotension, fever and a tender abdomen. History included prostate cancer, deep vein thrombosis and pulmonary embolism (DVT/PE) (on warfarin), essential thrombocytosis, portal vein thrombosis, and heparin induced thrombosis--thrombocytopenia syndrome (HITTS). Haemoglobin was stable and INR 2.3. CT revealed bleeding from a small region of peri-splenic veins. The patient was stabilized and INR reversed using prothrombinex. Clotting disorders were screened and indicated JAK-2 genetic disorder. Haematology recommended Fondaparinux, fresh frozen plasma, platelets, and tranexamic acid. On day 3 in ICU, blood pressure dropped, CT was repeated (Images 1, 2), and the patient was taken to theatre where he was found to have frank hemoperitoneum. Medtronic stapler was fired along bleeding vessels with successful hemostasis. Due to bleeding extent and risk of further injury, the decision was made to complete the operation. He then developed lower limb DVT where his access line was placed. ICU, hematology, general surgical and vascular teams all concluded it would be unsafe to anti-coagulate due to bleeding. DVT progressed to venous infarction and limb ischaemia. The patient was palliated and passed away from multiple organ failure. Conclusion: In this patient, raised venous pressures lead to variceal dilation and splenomegaly. Dilated, friable veins are prone to spontaneous rupture. Bleeding was exacerbated by warfarin and having a pre-existing clotting disorder. Ultimately the balance between managing his clotting issues and preventing further bleeding was too delicate to be maintained. Despite prompt diagnosis, this case was not traumatic, making management decisions difficult. This case aims to add to the database of this rare but fatal condition.
Biography

Theadora Forster-Anderson is a Surgical Registrar practicing in a service role at Fiona Stanley Hospital in Perth. She was recently posted at Gosford Hospital in New South Wales (NSW), where this case was encountered. She is interested in the field of General Surgery including the evaluation and management of trauma cases. She is a Consultant General Surgeon practicing on the Central Coast in NSW.

image PDF   |   image HTML
 

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version