Sepsis with spontaneous splenic rupture and hemorrhage: A case report

Severe infections due to sepsis often result in multi-organ insufficiency, such as cardiac insufficiency, renal insufficiency, hypohepatia, septic encephalopathy, coagulation dysfunction etc. Severe infections not only cause inflammatory storm, but also induce spleen abscess, and even combined with spontaneous splenic rupture hemorrhage. Spontaneous splenic rupture has an insidious onset, usually without a history of trauma, and is easily missed diagnosis. In this case, the patient with sepsis had sudden onset of abdominal pain and progressive decrease in hematocrit, thus the abdominal CT was immediately performed. The perisplenic mixed high-density shadow indicated splenic hemorrhage. After consultation with the department of hepatobiliary surgery, emergency dissection was performed. Splenic hematoma and laceration were found during the operation, thus total splenectomy was conducted. Pathological indicated chronic inflammatory cell infiltration of spleen, spleen abscess with bleeding. After operation, the patient's hematocrit was stable, abdominal pain improved significantly, and he was discharged from hospital after systematic therapy.