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"splenic rupture"

Case Report
Subcapsular Splenic Hemorrhage in Vivax Malaria
Jae Hyoung Im, Moon-Hyun Chung, Areum Durey, Jin-Soo Lee, Tong-Soo Kim, Hea Yoon Kwon, Ji Hyeon Baek
Korean J Parasitol 2019;57(4):405-409.
Published online August 31, 2019
DOI: https://doi.org/10.3347/kjp.2019.57.4.405
In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.
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