Splenic rupture during occlusion of the porta hepatis in resection of tumors with vena caval extension.

The surgical management of renal cell carcinoma with intraluminal extension into the vena cava is technically demanding. Although the curative merit of the procedure is well established, extension of tumor above the hepatic veins may cause potentially life threatening complications, including pulmonary embolus and exsanguination. To our knowledge we report the first 2 cases in which intraoperative splenic rupture occurred and discuss possible causes of this complication.