Ann Surg Treat Res.  2014 Jul;87(1):44-46. 10.4174/astr.2014.87.1.44.

Spontaneous splenic rupture in Plasmodium vivax malaria

• Kim KM
• Bae BK
• Lee SB

• KMID: 1804099
• DOI: http://doi.org/10.4174/astr.2014.87.1.44

Abstract

Malaria can present with various clinical symptoms and complications. While a tertian malaria form that is especially prevalent in Korea is characterized by mild clinical progression, occasional splenic complications are known to occur. A 26-year-old Korean male soldier without prior medical history visited The Armed Forces Capital Hospital with left upper quadrant abdominal pain one day ago. Hemostasis under laparoscopic approach was attempted. The operation was converted into laparotomy due to friable splenic tissue and consequently poor hemostasis. Splenectomy was performed. The patient was discharged at postoperative day 17 without complication. While numerous diseases can result in splenic complications, such as splenic rupture, malarial infection is known as the most common cause. The incidence of malarial infection in Korea is increasing annually, and there are occasional reports of splenic rupture due to the infection, which requires attention.

Keyword

Spleen; Spontaneous rupture; Vivax malaria

MeSH Terms

Abdominal Pain
Adult
Arm
Hemostasis
Humans
Incidence
Korea
Laparotomy
Malaria
Malaria, Vivax*
Male
Military Personnel
Rupture, Spontaneous
Spleen
Splenectomy
Splenic Rupture*

Figure

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  Fig. 1 Abdominal compute tomography finding reveal splenomegaly, perisplenic fluid collection, and hematoma.

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  Fig. 2 (A) Laparoscopic operative finding reveals perisplenic fluid collection, hematoma. (B) After removing perisplenic hematoma, capsular rupture approximately 10 cm in length was found, as well as continual bleeding.

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  Fig. 3 Microscopic findings of spleen. Malarial pigment (hemozoin) is seen in macrophages and endothelial cells lining sinus (H&E, ×400).

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