Spontaneous rupture of the spleen in chronic calcifying pancreatitis: report of three cases
Rahili, A.; Karimdjee, B.Soilihi.; Hastier, P.; Myx, A.; Juwid, A.; Benchimol, D.; Bourgeon, Aé.
Gastroenterologie Clinique et Biologique 29(5): 604-606
2005
ISSN/ISBN: 0399-8320 PMID: 15980759 Document Number: 586787
Spontaneous rupture of the spleen is a rare complication of chronic calcifying pancreatitis. Anemia and hemorrhagic shock may not occur, making diagnosis more difficult. Favourable response to conservative treatment does not prevent the need for splenectomy, as calcifiying chronic pancreatitis may progress locally. We report three cases of spontaneous rupture of the spleen. In two cases, splenic rupture revealed calcifying chronic pancreatitis and both patients underwent urgent splenectomy. In the third case, the patient was known to have calcifying chronic pancreatitis, and splenectomy was performed because of unsuccessful conservative treatment. We discuss the role of distal pancreatectomy during splenectomy to reduce the rate of postoperative complications and additional surgery. We also discuss the role of arterial embolisation and laparoscopy in the management of this rare condition.