Splenic artery pseudoaneurysm due to seatbelt injury in a glucose-6-phosphate dehydrogenase-deficient adult.
- Author:
Yu Zhen LAU
1
;
Yuk Fai LAU
;
Kang Yiu LAI
;
Chu Pak LAU
Author Information
1. Cardiac Heart Health Centre, Suite 1303, Central Building, 3 Pedder Street, Central, Hong Kong, China. cplau@hkucc.hku.hk.
- Publication Type:Case Reports
- MeSH:
Abdominal Pain;
diagnosis;
etiology;
Accidents, Traffic;
Aneurysm, False;
diagnostic imaging;
etiology;
therapy;
Embolization, Therapeutic;
methods;
Follow-Up Studies;
Glucosephosphate Dehydrogenase Deficiency;
complications;
diagnosis;
Humans;
Injury Severity Score;
Male;
Rare Diseases;
Risk Assessment;
Seat Belts;
adverse effects;
Splenic Artery;
injuries;
Tomography, X-Ray Computed;
methods;
Treatment Outcome;
Wounds, Nonpenetrating;
complications;
diagnosis;
Young Adult
- From:Singapore medical journal
2013;54(11):e230-2
- CountrySingapore
- Language:English
-
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 × 10(9)/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.
