Pregledni rad
https://doi.org/10.26800/LV-145-supl4-3
Spleen injury during vaginal delivery in a parturient with undiagnosed Non-Hodgkin lymphoma
Sanja Berić
; Klinička bolnica Sveti Duh, Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Zagreb, Hrvatska
Mark Žižak
orcid.org/0009-0005-2140-0147
Tamara Murselović
Višnja Nesek Adam
orcid.org/0000-0002-6521-4136
Sažetak
Splenic rupture during pregnancy most commonly occurs in the third trimester or postpartum period and can be traumatic, spontaneous, or pathological. Among malignant diseases diagnosed during pregnancy, hematological malignancies rank second after breast cancer. Lymphoma is the fourth most common malignancy during pregnancy, with Hodgkin’s lymphoma being the most frequently diagnosed among them. In this case report, we present a 35-year-old mother who experienced a decrease in red blood cell count following a vaginal delivery with the application of Kristeller maneuver. Radiological examination (MSCT) confirmed hepatosplenomegaly and suspected rupture of the cranial pole of the spleen with a subcapsular hematoma, accompanied by enlarged and multiplied abdominal and pelvic lymph nodes. The patient was admitted to the intensive care unit, where ongoing blood product transfusion was continued. A multidisciplinary approach involving surgeons and hematologists concluded that operative intervention was necessary. Surgical exploration confirmed a subcapsular hematoma of the spleen. Splenectomy was performed, followed by histopathological examination of the spleen. The pathological diagnosis revealed follicular non-Hodgkin’s lymphoma with transformation into high-grade aggressive diffuse large B-cell lymphoma (DLBCL). As the patient had been previously healthy without palpable peripheral lymph nodes, splenectomy was the only way to confirm the diagnosis of lymphoma. In this case report, if the spleen injury had not occurred during vaginal delivery, the patient’s serious illness would have remained unknown.
Ključne riječi
SPLEEN INJURY; NON-HODGKIN LYMPHOMA; PARTURIENT
Hrčak ID:
310054
URI
Datum izdavanja:
20.11.2023.
Posjeta: 224 *