Splenic trauma in a patient with portal hypertension and splenomegaly: A case report


  • Ahmet Topçu
  • Fatih Başak


Splenic trauma, Splenomegaly


The spleen is the most commonly injured organ in cases of blunt abdominal trauma. Currently, 50-80% of adults with blunt splenic injuries are treated nonoperatively. In this report, we present a blunt abdominal trauma patient having a history of portal hypertension and splenomegaly. In grade 3 and even grade 4 splenic injuries non-operative treatment is recommended in current literature. Management of splenic trauma with a patient with history of splenomegaly and portal hypertension is insufficiently discussed in literature. In presented case, hypersplenism and portal hypertension were burden on hemostasis. Even with massive resuscitation, thrombocyte level decreased to 40.000/mm³ after five hours. But, insistence on non-operative treatment in this situation could be fatal.  


Download data is not yet available.


Sartorelli KH, F rumiento C, Rogers FB, e t al. Nonoperative management of hepatic, splenic, and renal injuries in adults with multiple injuries. J Trauma 2000;49:56–61.

Dent D, A lsabrook G, Erickson BA, e t al. Blunt splenic injuries: high nonoperative management rate can be achieved with selective embolization. J Trauma 2004;56:1063–1067.

Richardson JD . Changes in the management of injuries to the liver and spleen. J Am Coll Surg 2005;200:648–669.

Galvan DA, Peitzman AB . Failure of nonoperative management of abdominal solid organ injuries. Curr Opin Crit Care 2006;12:590–594.

Sugawara Y, Y amamoto J, Shimada K, e t al. Splenectomy in patients with hepatocellular carcinoma and hypersplenism. J Am Coll Surg 2000;190:446–450.

Rutledge R . The increasing frequency of nonoperative management of patients with liver and spleen injuries . Adv Surgery 1997;30:385–415.

Velmahos GC, T outouzas KG, Radin R, e t al. Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg 2003;138:844–51.

Haan JM, B ochicchio GV, Kramer N, e t al. Nonoperative management of blunt splenic injury: a 5-year experience. J Trauma 2005;58:492–498.

Stein DM, Scalea TM . Nonoperative management of spleen and liver injuries. J Intensive Care Med 2006;21:296–304.

Maddrey WC . Alcohol-induced liver disease. Clin Liver Dis 2000;4:115–131.

Lauer GM, Walker BD . Hepatitis C virus infection. N Engl J Med 2001;345:41–52 .

Alter HJ, Seeff LB . Recovery, persistence, and sequelae in hepatitis C virus infection: a perspective on long-term outcome. Semin Liver Dis 2000;20:17–35.

Fang JF, C hen RJ, Lin BC, e t al. L iver cirrhosis: an unfavorable factor for nonoperative management of blunt splenic injury. J Trauma 2003;54:1131 –1136.

Matar HE, Elmetwally AS, Nair MS, Borgstein R, Oluwajobi O. Traumatic splenectomy in a cirrhotic patient with hepatitis C and alcoholic liver disease. BMJ Case Rep 2012;2012.






Case Report

How to Cite

Topçu A, Başak F. Splenic trauma in a patient with portal hypertension and splenomegaly: A case report. J Surg Med [Internet]. 2017 Aug. 20 [cited 2024 May 25];1(2):38-9. Available from: https://jsurgmed.com/article/view/344391