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Korean J Med > Volume 94(6); 2019 > Article
Nephrology
The Korean Journal of Medicine 2019;94(6): 526-529.
복막투석 환자에서의 비자발적 비장 파열 1예
이상희1, 이동영1, 문경협1, 김현정1, 이미지2, 김희서3, 김범1
1중앙보훈병원 신장내과
2중앙보훈병원 병리과
3광명성애병원 신장내과
Spontaneous Splenic Rupture in a Peritoneal Dialysis Patient
Sang Hee Lee1, Dong-Young Lee1, Kyoung Hyoub Moon1, Hyeon Jeong Kim1, Mi-Ji Lee2, Hui Seo Kim3, Beom Kim1
1Division of Nephrology, Department of Internal Medicine, Veterans Healthcare System Medical Center, Seoul, Korea
2Department of Pathology, Veterans Healthcare System Medical Center, Seoul, Korea
3Department of Nephrology, Gwangmyeong Sungae Hospital, Gwangmyeong, Korea
Corresponding Author: Beom Kim ,Tel: +82-2-2225-1306, Fax: +82-2-2225-1361, Email: glom@hanafos.com
Received: May 16, 2019;   Revised: May 20, 2019;   Accepted: May 22, 2019.
ABSTRACT
Atraumatic splenic rupture (ASR) in a patient undergoing peritoneal dialysis (PD) is uncommon, but can be life-threatening. According to recent systematic reviews, the major causes of ASR are 1) neoplastic (30.3%), 2) infectious (27.3%), 3) non-infectious inflammatory (20.0%), 4) iatrogenic (9.2%), 5) mechanical (6.8%), and 6) idiopathic (6.4%). It is diagnosed by imaging studies, most commonly ultrasonography and computed tomography (CT). Due to its rarity, the early diagnosis of ASR is difficult, and no standard treatment has been described. Here, we report a case of idiopathic ASR in a patient undergoing PD. The diagnosis was established by abdominal CT scan, and splenectomy was performed. Thus, hemoperitoneum in a PD patient should raise suspicion of ASR. Early diagnosis and appropriate treatment will lead to a better outcome.
Keywords: Hemoperitoneum; Atraumatic splenic rupture; Peritoneal dialysis
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