Citation

Lau YZ, Lau YF, Lai KY, Lau CP. Singapore Med. J. 2013; 54(11): e230-2.

Affiliation

Cardiac Heart Health Centre, Suite 1303, Central Building, 3 Pedder Street, Central, Hong Kong, China. cplau@hkucc.hku.hk.

Copyright

(Copyright © 2013, Singapore Medical Association)

DOI

unavailable

PMID

24276111

Abstract

A 23-year-old man presented with abdominal pain after suffering blunt trauma caused by a seatbelt injury. His low platelet count of 137 ×109/L was initially attributed to trauma and his underlying hypersplenism due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Despite conservative management, his platelet count remained persistently reduced even after his haemoglobin and clotting abnormalities were stabilised. After a week, follow-up imaging revealed an incidental finding of a pseudoaneurysm (measuring 9 mm × 8 mm ×10 mm) adjacent to a splenic laceration. The pseudoaneurysm was successfully closed via transcatheter glue embolisation; 20% of the spleen was also embolised. A week later, the platelet count normalised, and the patient was subsequently discharged. This case highlights the pitfalls in the detection of a delayed occurrence of splenic artery pseudoaneurysm after blunt injury via routine delayed phase computed tomography. While splenomegaly in G6PD may be a predisposing factor for injury, a low platelet count should arouse suspicion of internal haemorrhage rather than hypersplenism.

Language: en