Document Detail


Spontaneous splenic rupture complicating anticoagulant or thrombolytic therapy.
MedLine Citation:
PMID:  8475938     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To characterize the clinical course and outcomes of reported cases of splenic hemorrhage during thrombolytic or anticoagulant therapy. METHODS: The Medline, EMBASE (Excerpta Medica), BIOSIS, and SCISEARCH databases for English and foreign literature between 1966 and 1991 were searched. All reports of patients with documented splenic hemorrhage during anticoagulant therapy or thrombolytic therapy were reviewed. Foreign language manuscripts were translated into English. RESULTS: Seventeen cases of splenic hemorrhage associated with anticoagulant or thrombolytic therapy were found. In one case, there was minor antecedent trauma; in the remaining cases, hemorrhage was spontaneous. Mortality overall was 24% and was more likely in patients with splenic hemorrhage after thrombolytic therapy (50%) than in patients receiving long-term anticoagulants (9%). Splenectomy was performed in 12 of 13 survivors. CONCLUSIONS: Splenic hemorrhage associated with anticoagulant or thrombolytic therapy is a rare entity. It may be lethal, especially when associated with lytic therapy. Reversal of the anticoagulated or lytic state and emergent splenectomy are the treatment of choice. Splenic hemorrhage can mimic acute myocardial infarction and cardiogenic shock and must be considered when the condition of cardiac patients receiving lytic or anticoagulant drugs suddenly deteriorates.
Authors:
J C Blankenship; M Indeck
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of medicine     Volume:  94     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-20     Completed Date:  1993-05-20     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  433-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania 17822.
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / adverse effects*
Cause of Death
Diagnosis, Differential
Humans
Incidence
Laparotomy
Organ Size
Peritoneal Lavage
Risk Factors
Splenectomy / statistics & numerical data
Splenic Rupture / chemically induced,  epidemiology*,  therapy
Survival Rate
Thrombolytic Therapy / adverse effects*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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