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October 17, 1980

Iatrogenic Splenic Trauma

Author Affiliations

University of Miami Miami

JAMA. 1980;244(16):1784. doi:10.1001/jama.1980.03310160012012

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To the Editor.—  I have been recently required through consultations to perform splenectomies on two patients who had undergone needle treatments of the left lower lateral thoracic region. In the first instance thoracentesis had been attempted, and, in the second case, a left kidney biopsy had been done. In both cases, numerous passes of the needle had been made. On both occasions, the patient reported acute onset of left lateral thoracoabdominal pain immediately after the procedure, and in both cases, a slow but substantial decline in hemoglobin and hematocrit levels ensued. At laparotomy, splenic lacerations were found, with hemoperitoneum in one patient, and a huge subcapsular and pericapsular hematoma was found in the other.I had not heretofore encountered this complication. I recommend to interested clinicians that whenever needle insertions of the left lower thoracic region, ie, thoracentesis or renal biopsy, are followed by serious pain, especially where the needle