Splenic Rupture in Systemic Amyloidosis – Case Presentation and Review of the Literature

Zusammenfassung

Einleitung: Die Milzruptur und Blutung in den Bauchraum ist eine äußerst ungewöhnliche und seltene Komplikation einer internistischen Krankheit. Mögliche Ursachen für eine solche Komplikation sind Blut-, Entzündungs- oder Infiltrationskrankheiten, welche die Milz affizieren. Die Milzvergrößerung ist ein Faktor, der das Risiko einer Milzruptur signifikant erhöht. Fallbericht: Die Autoren stellen einen 52-jährigen Patienten mit festgestellter systemischer Amyloidose vor. Zuvor wurde er wegen einer undefinierten Leberkrankheit und Anämie behandelt, die bei der Behandlung pathologischer Wirbelbrüche festgestellt wurden. Leider willigte er während der ersten Behandlung in eine Leberbiopsie zur Bestimmung der Ätiologie der Krankheit nicht ein. Die systemische Infiltrationskrankheit wurde posthum bestimmt; die Milz sowie andere Organe waren betroffen. Es werden jene Formen der Amyloidose beschrieben, welche gewöhnlich einen ungünstigen Krankheitsverlauf bedeuten. Schlussfolgerung: Es wird ein Patient mit einer seltenen Form von Amyloidose und einer tödlichen Komplikation, Milzruptur, vorgestellt.

Abstract

Introduction: Splenic rupture and hemorrhage into the abdominal cavity is an extremely unusual and rare complication of internal disease. Hemopathies, inflammatory or infiltrative diseases affecting the spleen are possible causes for such a complication. Splenomegaly is a factor, which may significantly increase the risk of rupture. Case Report: The authors present the case of a 52-year-old patient with established systemic amyloidosis. In the past he had received treatment for undefined hepatic disease and anemia, which was established during the treatment of pathological vertebral fractures. Unfortunately, during the initial treatment he did not consent to a liver biopsy, which would have determined the etiology of the disease. Systemic infiltrative disease, affecting the spleen and other organs, was confirmed posthumously. Described are those forms of amyloidosis which usually represent an unfavorable course of the disease. Conclusion: Presented is a patient with a rare form of primary amyloidosis and fatal complication, spleenic rupture.

Schlüsselwörter

Milz - Ruptur - Infiltrationskrankheit - Leber - Amyloidose - Komplikationen

Key words

spleen - rupture - infiltrative diseases - liver - amyloidosis - complications

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