Blunt trauma to the abdomen and surgery !
This is a 29-year-old man who have suffered a blunt trauma to the abdomen, subsequently causing a huge subcapsular splenic hematoma. This was an emergency case because of big risk of ruptured spleen which will lead to shock and death. Hematomas of the spleen are usually associated with trauma, or infectious, neoplastic, or hematologic diseases. They present a diagnostic challenge as they can be easily confused with other more common entities. The spleen is a very vascularized organ and injury to this organ can result in significant blood loss either from the parenchyma or the arteries and veins that supply the spleen. The spleen may lacerate or rupture in an event of trauma to the lower left chest or the upper left abdomen. Traumatic hemorrhage or rupture of a normal spleen is a common result of high velocity trauma. A pathologic splenic hematoma is less frequently encountered secondary to diseases affecting the reticuloendothelial system (Epstein–Barr virus infection, cytomegalovirus infection, hepatitis, malaria) or neoplasia (lymphoma, leukemia). Surgical intervention with laparoscopic splenectomy is the ultimate diagnostic and curative approach in patients with ongoing bleeding or hemodynamic instability. If left untreated, patients may progress to develop fatal and life-threatening complications such as gross internal bleeding which may lead to coma.