Case Report
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World J Gastroenterol. Dec 14, 2014; 20(46): 17670-17673
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17670
Emergency laparoscopic partial splenectomy for ruptured spleen: A case report
Yun-Qiang Cai, Chun-Lin Li, Hua Zhang, Xin Wang, Bing Peng
Yun-Qiang Cai, Chun-Lin Li, Hua Zhang, Xin Wang, Bing Peng, Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Cai YQ and Peng B designed the research; Cai YQ, Li CL, Zhang H and Wang X performed the research and wrote the paper; Peng B proofread and revised the manuscript; all authors approved the version to be published.
Correspondence to: Bing Peng, MD, Professor, Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, No 37, Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. marsfriend@163.com
Telephone: +86-28-85422477 Fax: +86-28-85422474
Received: April 29, 2014
Revised: June 16, 2014
Accepted: July 16, 2014
Published online: December 14, 2014
Processing time: 233 Days and 7.5 Hours
Abstract

Splenic rupture is a common consequence of blunt abdominal trauma. Emergency splenectomy is indicated when conservative management is not effective. With better understanding of the immunologic function of the spleen, surgeons have begun to perform the splenic-preserving surgery. However, it is technical challenge to perform emergency laparoscopic partial splenectomy for patient with spleen rupture. A 15-year-old male patient suffered from grade III spleen injury basing on the American association for the surgery of trauma splenic injury scale. Conservative treatment failed to success basing on the dramatically decreased hemoglobin level. During the laparoscopic exploration, we found that two individual ruptures were associated with the upper pole of spleen. An emergency laparoscopic partial splenectomy was successfully carried out. The operative time was approximate 150 min and the estimated blood loss was 200 mL. The post-operative course was uneventful and the patient was discharged on the 7th post-operative day.

Keywords: Laparoscopy; Minimal invasive; Partial splenectomy; Splenic rupture; Splenic trauma

Core tip: It is technical challenge to perform laparoscopic partial splenectomy for patient with spleen rupture because of fragile parenchyma and abundant blood supply. We report a case of successfully laparoscopic partial splenectomy for ruptured spleen, with ordinary laparoscopic instruments. We also shared our experience in laparoscopic partial splenectomy in this case report.