Peliosis of the spleen: splenic rupture with intraperitoneal hemorrhage

Shimono, Taro; Yamaoka, T.; Nishimura, K; Naya, Mayumi; Hojo, Makoto; Yamamoto, Eiji; Mukaihara, Sumio; Hayakawa, Katsumi

doi:10.1007/s002619900323

Cited by 19 publications

(13 citation statements)

References 5 publications

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“…Fortunately, our patient was a previously healthy young man and was able to compensate for the large intravascular volume loss prior to diagnosis. Other patients with splenic peliosis have presented with pain in the left hypochondrium 10,11,13 and splenomegaly, 14 as well as with features of any of the associated medical conditions.…”

Section: Discussionmentioning

confidence: 99%

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'Not just another appendicitis!' – a case report of acute abdominal pain caused by splenic rupture secondary to isolated splenic peliosis

Qureshi

Choong²,

Tadrous³

et al. 2009

Ann R Coll Surg Engl

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Case historyA previously healthy 31-year-old Polish male presented to the accident and emergency department with suddenonset of abdominal pain. The pain followed an alcohol binge 8 h prior to his presentation and was generalised and constant in nature. There was no history of trauma related to his excessive alcohol intake. There was one episode of vomiting but no other bowel or urinary symptoms. He also complained of pain in his left shoulder.On physical examination, the abdomen was soft and non-distended. Tenderness was elicited all over the abdomen but was more severe in the epigastric region and right loin with mild guarding. There was no rebound tenderness or rigidity. There were no masses or organomegaly to find. He was afebrile and no abnormalities were detected in the cardiovascular and respiratory examinations. His blood pressure was 130/85 mmHg and heart rate was 83 bpm.Laboratory tests demonstrated a raised white blood cell count of 13.7 × 10 9 /l (normal range, 4.5-11.0 × 10 9 /l) and a C-reactive protein of 16 mg/l (normal range, 0-8 mg/l). Renal, liver function tests, serum amylase and clotting profile were all within normal limits. An erect chest and abdominal radiograph did not reveal any abnormalities. Abdominal ultrasound showed a large amount of abdominopelvic free fluid. The liver was normal in echoic texture with no focal lesions, and the pancreas and kidneys were also normal. The spleen was 'Not just another appendicitis!' -a case report of acute abdominal pain caused by splenic rupture secondary to isolated splenic peliosis ABSTRACTWe present the case of a 31-year-old man admitted with acute abdominal pain who was subsequently found to have a ruptured spleen. A splenectomy was performed as an emergency and he was discharged from hospital 4 days later. Histological analysis revealed isolated splenic peliosis as the underlying condition predisposing to his splenic rupture.

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Section: Discussionmentioning

confidence: 99%

“…10 However, due to the rarity of splenic peliosis, many of the characteristic imaging results are deduced from peliosis hepatis. The radiological differential diagnosis of peliosis includes hemangiomatosis, lymphangioma, and angiosarcoma.…”

Section: Discussionmentioning

confidence: 99%

'Not just another appendicitis!' – a case report of acute abdominal pain caused by splenic rupture secondary to isolated splenic peliosis

Qureshi

Choong²,

Tadrous³

et al. 2009

Ann R Coll Surg Engl

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“…This is usually an incidental finding noted in an asymptomatic individual, however spontaneous splenic rupture has been reported [ 36 ] . On CT, multiple small well-defined, hypodense cyst-like lesions are seen (Fig.…”

Section: Metastatic Lesionsmentioning

confidence: 99%

Review: Primary and secondary neoplasms of the spleen

Kaza¹,

Azar²,

Al-Hawary³

et al. 2010

Cancer Imaging

108

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“…Approximately 40 cases of isolated splenic peliosis have been reported in the literature (68). Most cases have an association with use of anabolic steroids; hematologic disorders such as aplastic ane-mia; and wasting diseases such as tuberculosis, AIDS, and cancer (69,70). Peliosis is often discovered incidentally, but its clinical significance lies in the potential of peliotic lesions on the surface of the spleen to rupture and cause life-threatening intraperitoneal hemorrhage.…”

Section: Peliosis Clinical Featuresmentioning

confidence: 99%

From the Archives of the AFIP

Abbott¹,

Levy²,

Aguilera³

et al. 2004

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332

125

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Primary vascular neoplasms of the spleen constitute the majority of nonhematolymphoid splenic tumors. The benign primary vascular tumors include hemangioma, hamartoma, and lymphangioma, whereas those of variable or uncertain biologic behavior include littoral cell angioma, hemangioendothelioma, and hemangiopericytoma. The primary malignant vascular neoplasm of the spleen is angiosarcoma. Peliosis is a rare lesion of unknown cause that is usually found incidentally in asymptomatic patients but may be associated with hematologic or metastatic disease. Although these vascular neoplasms of the spleen are uncommon, their importance lies in that they must be differentiated from the more common neoplastic disorders of the spleen, such as lymphoma and metastasis. The most common echogenic solid or complex cystic mass in an asymptomatic patient is splenic hemangioma. However, the imaging appearance of splenic hemangiomas may be complex, and differentiation of these lesions from malignant disease may not be possible. The diagnosis of splenic hamartoma may be suggested when findings of increased blood flow on color Doppler images are seen in association with a homogeneous solid echogenic mass. A large subcapsular solitary cystic abnormality discovered incidentally in a child in association with internal septations and tiny mural nodules favors the diagnosis of lymphangioma. Any invasion of the surrounding splenic parenchyma by a splenic lesion should indicate a more aggressive or malignant process. Evaluation of a focal splenic abnormality identified on sonograms should be followed up with computed tomography or magnetic resonance imaging with and without contrast material enhancement. Splenectomy may be required for definitive evaluation of a splenic mass with atypical features.

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Peliosis of the spleen: splenic rupture with intraperitoneal hemorrhage

Abstract: Peliosis is a rare disease that is characterized by multiple blood-filled cystic spaces. We report the computed tomographic findings of splenic rupture secondary to splenic peliosis in a patient receiving anabolic steroids for aplastic anemia.

Cited by 19 publications

References 5 publications

'Not just another appendicitis!' – a case report of acute abdominal pain caused by splenic rupture secondary to isolated splenic peliosis

'Not just another appendicitis!' – a case report of acute abdominal pain caused by splenic rupture secondary to isolated splenic peliosis

Review: Primary and secondary neoplasms of the spleen

From the Archives of the AFIP

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