• J Coll Physicians Surg Pak · Jul 2022

    Case Reports

    Delayed Splenic Rupture due to an Occult Primary Injury.

    • Junaid Zia Hashmi, Masood Ur Rauf Khan Hiraj, Farah Saleem, Usman Malik, and Imran Khan Mazari.
    • Department General Surgery Unit IV, Nishtar Hospital, Multan, Pakistan.
    • J Coll Physicians Surg Pak. 2022 Jul 1; 32 (7): 931-933.

    AbstractSpleen, due to its unique position and relative mobility, is the most vulnerable organ in blunt abdominal injuries. After splenic trauma, hemodynamically unstable patients are treated with splenectomy. Delayed splenic rupture presents 48 to 72 hours after blunt abdominal trauma and is a rare entity. It is usually associated with low-velocity blunt injuries. The sequela is usually a minor trauma that is concealed initially and presents later as subcapsular hematoma, hemodynamic instability, abdominal pain, and positive Kehr's sign in most cases. Computed tomography is the investigation of choice in such cases. We discuss here a case of delayed splenic rupture that presented after eight weeks of a minor abdominal injury due to a fall. The patient presented with a tender left hypochondrium, positive Kehr's sign, and tachycardia. Computed tomography of the abdomen revealed delayed splenic rupture and hemoperitoneum. As the initial imaging is usually normal in these cases, a routine follow-up and close monitoring of trauma patients can help in the early detection of complications. Key Words: Splenectomy, Splenic rupture, Kehr's sign, Hemoperitoneum.

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