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Rehabilitation Practice and Science

Translated Title

頸髓損傷病人出現遲發性脾破裂：病例報告

Abstract

This is a report of a 65-year-old male patient with incomplete spinal cord injury caused by a traffic accident. He was robust prior to this injury. He was hospitalized due to tetraplegia caused by the accident, and did not lose consciousness at the time of injury. A cervical spine MRI was performed and showed cervical spondylosis with a C4-5, C5-6 herniated intervertebral disc. After decompressive surgery, he was transferred to our ward for inpatient rehabilitation, where balance and exercise activities on a mattress were carried out regularly. After 20 days of rehabilitation, acute dyspnea, abdominal distension and unstable vital signs were noted. His hemoglobin dropped from 11.7 mg/dl to 6.4 mg/dl. An emergency abdominal CT was arranged and this showed spleen rupture with a massive hemoperitoneum. Our radiologist performed splenic artery angiography with embolization and a follow up abdominal CT did not show any new bleeding. The patient's condition is currently stable and he is receiving outpatient treatment.This article mainly discusses how a patient with cervical cord injury may have abdominal discomfort related to unknown internal bleeding, particularly after a previous abdominal injury. In these circumstances, a differential diagnosis involving acute injury to the abdomen, especially the spleen, cannot be ignored. The pathophysiology is that the capsule of the spleen should protect the spleen from injury, but an elevation of pressure in the abdomen such as by coughing, sneezing or defecation may result into internal bleeding. Delayed splenic rupture is not common among patients with spinal cord injury and therefore we have described this case in order to share our experiences with this problem.

Language

Traditional Chinese

First Page

53

Last Page

57

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