Document Type : Case Report
Authors
1 Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
2 Alex Ekwueme Federal University Teaching Hospital, Abakaliki
Abstract
Objective: The spleen is the most frequently injured organ in blunt abdominal trauma (BAT). We present an interesting case of traumatic splenic rupture in pregnancy managed successfully by emergency splenectomy in a low-resource setting.
Case Presentation: A 27-year old multiparous woman at 23 weeks gestational age presented to the emergency department with a history of BAT following a road traffic accident (RTA). This study was conducted in the Department of Surgery, General Surgery Unit, College of Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi State, Southeast Nigeria, in 2023. A vehicle strayed and hit her from the left side of the abdomen while she was sitting down. She suddenly developed abdominal pain, bruises on the left upper abdomen, and
progressive abdominal distension. The abdominal ultrasound report showed a deep trabecular laceration and massive hemoperitoneum. The fetus was viable from obstetric and ultrasound assessments. The patient was hemodynamically unstable and was subsequently prepared for emergency exploratory laparotomy. Intraoperatively, incomplete hilar avulsion injury and multiple parenchymal lacerations of the spleen were noted. An accessory spleen without injury was also noted. Splenectomy with preservation of the accessory spleen was performed.
Postoperatively, the fetus remained viable, and the patient was hemodynamically stable. The mother had no morbidities other than paralytic ileus and fever, and both were amenable to conservative management.
Conclusion: Emergency splenectomy is a life-saving procedure in hemodynamically unstable patients with splenic trauma, even in pregnancy.
Keywords
Main Subjects
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