第502例——血小板减少、巨脾、DIC、自发性脾破裂

The 502nd case:thrombocytopenia,splenomegaly,disseminated intravascular coagulation,and spontaneous rupture of the spleen

1例青年男性,既往血小板减少症7年余,本次因巨脾、发热起病,快速进展至弥散性血管内凝血(DIC)、失血性休克,考虑自发性脾破裂,急诊行脾切除术,组织病理学诊断为脾紫癜。脾紫癜罕见,病因及病理机制尚不明确。自发性脾破裂合并DIC死亡率极高,本例患者得以成功救治,本文分享诊治经过。

A young man with a history of thrombocytopenia for seven years presented with splenomegaly and fever and rapidly evolved to disseminated intravascular coagulation(DIC)and hemorrhagic shock.Spontaneous rupture of the spleen was diagnosed.The critical patient underwent an emergency splenectomy.Pathological examination revealed splenic peliosis,an extremely rare disease with unknown etiology and pathogenesis.Despite the high mortality rate due to spontaneous splenic rupture with DIC,the patient was successfully treated and the details of the case are presented in this report.