February 1980

Spontaneous Splenic Rupture in Acute Lymphoblastic Leukemia: Successful Nonoperative Management

Author Affiliations

Department of Hematology; Department of Pediatrics Children's Hospital of Michigan 3901 Beaubien Blvd Detroit, MI 48201; Department of Surgery Wayne State University School of Medicine Detroit, MI 48201

Am J Dis Child. 1980;134(2):201-202. doi:10.1001/archpedi.1980.02130140071019

Spontaneous rupture of the spleen is a rare complication in patients with acute leukemia.1-8 In most of the patients diagnosis has been made postmortem, though successful removal of the spleen has been accomplished in a few. Recently, we encountered a case of acute T-cell leukemia in which intraperitoneal bleeding and shock were due to splenic rupture. The patient's condition was managed successfully without surgical intervention.

Report of a Case.—A 13-year-old boy was admitted to Children's Hospital of Michigan, Detroit, on June 14, 1978, with a two-week history of mild difficulty in breathing, generalized petechiae, prominent bilateral cervical adenopathy, and hepatomegaly (5 cm) and splenomegaly (7 cm). The following laboratory values were reported: hemoglobin, 14.2 g/dL; WBCs, 174,000/cu mm, with 90% lymphoblasts; and platelets, 28,000/cu mm. Chest roentgenogram showed an enlarged thymus. Bone marrow examination confirmed the diagnosis of acute lymphoblastic leukemia, and the leukemic blasts formed spontaneous rosettes