Claire-Sophie Descamps1, Fabrice Cneude2, Stephane Hays3, Isabelle Rayet4, Christian Piolat5, Chloé Epiard2, Thierry Debillon2. 1. Service de Réanimation néonatale, Hôpital Couple Enfant Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France. csdescamps@chu-grenoble.fr. 2. Service de Néonatologie, Centre Hospitalier Universitaire de Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France. 3. Hôpital Croix Rousse, Service de Néonatologie, 103 Grande Rue de la Croix Rousse, 69004, Lyon, France. 4. Service de Néonatologie, Centre Hospitalier Universitaire Saint-Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France. 5. Service de Chirurgie Pédiatrique, Centre Hospitalier Universitaire de Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France.
Abstract
Splenic rupture in the neonatal period is a rare condition that can be complicated by hemorrhagic shock. The symptoms are not very specific, rendering the diagnosis difficult and often delayed; sometimes only discovered at autopsy. We report five cases diagnosed in the Rhône-Alpes region of France. From these observations and from a review of the literature, the circumstances of the occurrence, the clinical signs, and the therapeutic possibilities are discussed. In the presence of severe anemia with pallor and abdominal distension, particularly in the context of a difficult birth, an abdominal ultrasound must be urgently performed and surgical management promptly considered. CONCLUSION: This pathology must be known to the neonatologist so that she/he can quickly evoke it, given that it can quickly become life-threatening. What is known: • Splenic rupture in the neonatal period is a rare condition that can be complicated by hemorrhagic shock and quickly lead to the death of the newborn. • The symptoms are not very specific, rendering the diagnosis difficult and often delayed. What is new: • This is the first publication bringing together as many clinical cases on the subject reporting in particular very serious cases to alert the clinician on this pathology and its diagnostic urgency. • We propose a clear therapeutic behavior to help the clinician in his daily practice.
Splenic rupture in the neonatal period is a rare condition that can be complicated by hemorrhagic shock. The symptoms are not very specific, rendering the diagnosis difficult and often delayed; sometimes only discovered at autopsy. We report five cases diagnosed in the Rhône-Alpes region of France. From these observations and from a review of the literature, the circumstances of the occurrence, the clinical signs, and the therapeutic possibilities are discussed. In the presence of severe anemia with pallor and abdominal distension, particularly in the context of a difficult birth, an abdominal ultrasound must be urgently performed and surgical management promptly considered. CONCLUSION: This pathology must be known to the neonatologist so that she/he can quickly evoke it, given that it can quickly become life-threatening. What is known: • Splenic rupture in the neonatal period is a rare condition that can be complicated by hemorrhagic shock and quickly lead to the death of the newborn. • The symptoms are not very specific, rendering the diagnosis difficult and often delayed. What is new: • This is the first publication bringing together as many clinical cases on the subject reporting in particular very serious cases to alert the clinician on this pathology and its diagnostic urgency. • We propose a clear therapeutic behavior to help the clinician in his daily practice.
Authors: S Rekha; S Lewin; S Lilly; S Vincent; C Ramachandra; M K Chandrasekhara; M Yeshwanth Journal: Indian Pediatr Date: 1992-12 Impact factor: 1.411