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Acute Myeloid Leukemia and Spontaneous Splenic Rupture: Case Report

By: Kayci Reyer
Posted: Tuesday, July 6, 2021

A case study reported in the Annals of Medicine and Surgery described a patient with acute myeloid leukemia (AML) who experienced a spontaneous rupture of the spleen. Although this condition is uncommon, it is severe and difficult to diagnose, and AML has been identified as a potential cause.

“It is important to include splenic rupture as a differential diagnosis for acute abdominal pain, especially in patients with hematologic malignancy, since early recognition and treatment increase patient survival and improve the prognosis,” concluded Farid F. Chehab, PhD, of University Hospital Centre Ibn Rochd, Casablanca, and colleagues.

The case study described a patient, aged 41, who was receiving chemotherapy for AML and presented with acute severe abdominal pain. The patient underwent a CT scan that revealed a splenic rupture with abundant hemoperitoneum and bilateral pleural effusion. A splenectomy was immediately performed due to the patient’s hemodynamic instability.

Spontaneous splenic rupture may be difficult to diagnose, as its symptoms can be nonspecific, such as severe abdominal pain. Although CT scans and ultrasonography are the typical diagnostic tools used to confirm the condition, two signs may be looked for during a physical examination: Kehr’s sign, a left diaphragmatic irritation causing referred pain to the left shoulder, and Ballance’s sign, a palpable tender mass in the left upper quadrant.

Disclosure: The study authors reported no conflicts of interest.


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