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Journal of Case Reports
Spontaneous Intra-Abdominal Hemorrhage from Peri-Splenic Veins in an Atraumatic Patient
Theadora Forster-Anderson, Rita Poon 
Department of General Surgery, Gosford Hospital, Holden Street, Gosford, NSW, Australia, 2250.
Corresponding Author:
Dr. Theadora Forster-Anderson
Email: theadorafa@gmail.com
Received: 16-JUN-2017 Accepted: 01-OCT-2017 Published Online: 10-NOV-2017
DOI: http://dx.doi.org/10.17659/01.2017.0098
Abstract
Background: Isolated splenic vein bleeding without an intra-capsular splenic hemorrhage in the absence of trauma is extremely rare and not reported widely in the literature. We aim to describe a rare case of spontaneous, atraumatic peri-splenic hemorrhage to highlight the management dilemmas associated with the condition. Case Report: A 72 year-old gentleman presented with acute onset epigastric pain and nausea. His past medical history included portal vein thrombosis secondary to thrombocytosis for which he was on aspirin, and a deep vein thrombosis (DVT) and pulmonary embolus treated with warfarin. CT scan revealed a hemo-peritoneum and hemorrhage from peri-splenic veins. After failed conservative management he underwent a laparotomy for control of the bleeding. Post-operatively he developed an extensive DVT leading to limb ischemia and subsequently passed away. Conclusion: Peri-splenic venous hemorrhage in the absence of trauma is an extremely rare occurrence and is potentially fatal.
Keywords : Portal Vein, Postoperative Hemorrhage, Pulmonary Embolism, Splenic Vein, Venous Thrombosis.
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