以血性腹膜透析液为首发表现的外伤性延迟性脾破裂1例暨文献复习

doi:10.3760/cma.j.cn441417-20250219-13028

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (13): 2253-2256.DOI: 10.3760/cma.j.cn441417-20250219-13028

以血性腹膜透析液为首发表现的外伤性延迟性脾破裂1例暨文献复习

童金燕卢美芝雷子涵曹嘉琪李玉敏杨椹

广州市花都区人民医院肾病学科，广州 510800

收稿日期:2025-02-19 出版日期:2025-07-01 发布日期:2025-08-04
通讯作者: 杨椹，Email：13424028260@163.com
基金资助:
广州市医学重点学科建设项目（2025-2027年）；广州市卫生健康科技项目（20241A010101）

A case report and literature review of the delayed traumatic splenic rupture with hemorrhagic ascites as the first manifestation

Tong Jinyan, Lu Meizhi, Lei Zihan, Cao jiaqi, Li yumin, Yang Shen

Department of Nephrology, People's Hospital of Guangzhou Huadu District, Guangzhou 510800, China

Received:2025-02-19 Online:2025-07-01 Published:2025-08-04
Contact: Yang Shen,Email:13424028260@163.com
Supported by:
Guangzhou Medical Key Subject Construction Project (2025-2027); Guangzhou Health Science and Technology Project (20241A010101)

摘要/Abstract

摘要：

终末期肾衰竭腹膜透析患者常合并多种干扰因素，其并发症发生率和病死率相对较高。延迟性脾破裂因存在潜伏期，在临床上容易因漏诊或误诊而耽误治疗。作者回顾性分析了广州市花都区人民医院收治且成功治愈的1例首发表现为血性腹膜透析液，最终确诊为外伤导致延迟性脾破裂腹膜透析患者的病因、诊治经过及院外随访资料，旨在提高医务工作者对特殊人群并发延迟性脾破裂的认识，以助于该病的早期诊断和治疗。

关键词: 腹膜透析, 延迟性脾破裂, 外伤性, 血性腹膜透析液

Abstract:

Patients with end-stage renal failure undergoing peritoneal dialysis often present with multiple confounding factors, resulting in a relatively high incidence of complications and mortality. Delayed splenic rupture, due to its latent period, is often misdiagnosed or overlooked in clinical practice, leading to delays in treatment. The authors conducted a retrospective analysis of a successfully treated case in People's Hospital of Guangzhou Huadu District, where the initial manifestation was hemoperitoneum in peritoneal dialysis fluid, ultimately diagnosed as delayed splenic rupture due to trauma. This analysis includes the cause, treatment process, and follow-up data outside the hospital, aiming to enhance medical professionals'understanding of the complications of delayed splenic rupture in this special population, thereby aiding in early diagnosis and treatment.

Key words: Peritoneal dialysis, , Delayed splenic rupture, , Traumatic, , Hemorrhagic ascites

童金燕卢美芝雷子涵曹嘉琪李玉敏杨椹.

以血性腹膜透析液为首发表现的外伤性延迟性脾破裂1例暨文献复习 [J]. 国际医药卫生导报, 2025, 31(13): 2253-2256.

Tong Jinyan, Lu Meizhi, Lei Zihan, Cao jiaqi, Li yumin, Yang Shen.

A case report and literature review of the delayed traumatic splenic rupture with hemorrhagic ascites as the first manifestation [J]. International Medicine and Health Guidance News, 2025, 31(13): 2253-2256.

参考文献

[1]Goel N, Haddad DB, Jain D. Hemoperitoneum after cardiopulmonary resuscitation in peritoneal dialysis patients: a tale of two cases[J]. Int J Nephrol Renovasc Dis, 2020, 13: 379-383. DOI: 10.2147/IJNRD.S285969.

[2]Yamamoto T, Kadoya H, Urabe E, et al. A rare case of amyloid light-chain amyloidosis with bilateral perirenal hematoma shortly after initiation of peritoneal dialysis[J]. CEN Case Rep, 2021, 10(3): 326-331. DOI: 10.1007/s13730-020-00563-w.

[3]Yılmaz F, Bora F, Çetinkaya R, et al. A case of cyclic hemoperitoneum in a hemodialysis patient: encapsulated peritoneal sclerosis complicated by endometriosis and fungal peritonitis[J]. Semin Dial, 2021, 34(2): 176-179. DOI: 10.1111/sdi.12945.

[4]Kohn OF, Culbertson S, Becker YT. Hemoperitoneum in a peritoneal dialysis patient: ruptured ectopic pregnancy[J]. Perit Dial Int, 2018, 38(6): 455-456. DOI: 10.3747/pdi.2018.00066.

[5]Luni FK, Bawany MZ, Khan AR, et al. Haemoperitoneum post colonoscopy in a continuous ambulatory peritoneal dialysis patient[J]. Arab J Gastroenterol, 2014, 15(3-4): 159-60. DOI: 10.1016/j.ajg.2014.04.006.

[6]Kinoshita C, Quy PN, Honda M. Atraumatic splenic rupture in a peritoneal dialysis patient[J]. CEN Case Rep, 2018, 7(2): 296-300. DOI: 10.1007/s13730-018-0346-x.

[7]苏彩虹,黄丽秋,李红艳,等.腹膜透析患者规律性随访与发生并发症的相关性研究[J].国际医药卫生导报,2022,28(8):1057-1061.DOI:10.3760/cma.j.issn.1007-1245.2022.08.005.

[8]Gedik E, Girgin S, Aldemir M, et al. Non-traumatic splenic rupture: report of seven cases and review of the literature[J]. World J Gastroenterol, 2008, 14(43): 6711-6716. DOI: 10.3748/wjg.14.6711.

[9]Gascón A, Iglesias E, Bélvis JJ, et al. The elderly haemodialysis patient with abdominal symptoms and hypovolemic shock--splenic rupture secondary to splenic infarction in a patient with severe atherosclerosis[J]. Nephrol Dial Transplant, 1999, 14(4): 1044-1045. DOI: 10.1093/ndt/14.4.1044.

[10]Chau EM, Chan AC, Chan WK. Spontaneous atraumatic rupture of a normal-sized spleen due to AL amyloid angiopathy[J]. Amyloid, 2008, 15(3): 213-215. DOI: 10.1080/13506120802193357.

[11]Kountouri I, Vitkos EN, Dimasis P, et al. Spontaneous splenic rupture secondary to infectious mononucleosis[J]. Diagnostics (Basel), 2024, 14(14): 1536. DOI: 10.3390/diagnostics14141536.

[12]Hu S, Hao Y, Liu X, et al. Unusual symptoms reveal a rare splenic lymphoma: a case report of PS-DLBCL with neck and shoulder pain as the initial presentation[J]. Front Oncol, 2025, 15: 1449966. DOI: 10.3389/fonc.2025.1449966.

[13]Sivit CJ, Peclet MH, Taylor GA. Life-threatening intraperitoneal bleeding: demonstration with CT[J]. Radiology, 1989, 171(2): 430. DOI: 10.1148/radiology.171.2.2704807.

[14]Jones C, Sattler S, Gekle R. Traumatic splenic laceration with delayed rupture secondary to coughing in a patient with Von Willebrand disease[J]. Am J Emerg Med, 2021, 50: 812.e5-812.e7. DOI: 10.1016/j.ajem.2021.05.064.

[15]Genualdi J, Orach T, Gumbs S, et al. Traumatic rupture of cystic left retroperitoneal mass: an atypical presentation of diffuse large B-cell lymphoma[J]. Cureus, 2023, 15(4): e37797. DOI: 10.7759/cureus.37797.

[16]盛扬,杨露,彭涛,等.脑出血并迟发性脾破裂一例并文献复习[J].中国当代医药,2021,28(9):172-174. DOI:10.3969/j.issn.1674-4721.2021.09.048.

[17]El-Rifi K. The latent period of baudet[J]. Br J Surg, 1967, 54(3): 238-239. DOI:10.1002/bjs.1800540319.

[18]邱云峰,杜琪威,瞿敏,等.外伤性延迟性脾破裂的诊断与治疗[J].中华消化外科杂志,2014,13(12):943-946. DOI:10.3760/cma.j.issn.1673-9752.2014.12.007.

[19]Kluger Y, Paul DB, Raves JJ, et al. Delayed rupture of the spleen--myths, facts, and their importance: case reports and literature review[J]. J Trauma, 1994, 36(4):568-571.

[20]Shinkai T, Ono K, Masumoto K, et al. A rare mechanism of delayed splenic rupture following the nonoperative management of blunt splenic injury in a child[J]. Surg Case Rep, 2018, 4(1):75. DOI: 10.1186/s40792-018-0477-5.

[21]徐青.腹膜透析置管术患者导管移位的影响因素分析[J].国际医药卫生导报,2021,27(6):912-915. DOI:10.3760/cma.j.issn.1007-1245.2021.06.033.

[22]Barrea L, Di Somma C, Muscogiuri G, et al. Nutrition, inflammation and liver-spleen axis[J]. Crit Rev Food Sci Nutr, 2018, 58(18): 3141-3158. DOI: 10.1080/10408398.2017.1353479.

[23]叶丽,田川,赵晓娟,等.高活性脐带间充质干细胞干预老年树鼩衰老脾脏的作用与机制[J].中国组织工程研究,2025,29(19):4000-4010. DOI:10.12307/2025.047.

[24]姜洪池,周孟华.脾脏外科临床研究进展与展望[J].中国实用外科杂志,2020,40(1):53-57,61. DOI:10.19538/j.cjps.issn 1005-2208.2020.01.09.

[25]Kofinas AG, Stavrati KE, Symeonidis NG, et al. Non-operative management of delayed splenic rupture 4 months following blunt abdominal trauma[J]. Am J Case Rep, 2021, 22: e932577. DOI: 10.12659/AJCR.932577.

[26]刘川,谢长远,王伟林.创伤性脾破裂行保脾治疗的预后风险分析——单中心195例回顾性研究[J].浙江创伤外科,2022,27(1):1-4. DOI:10.3969/j.issn.1009-7147.2022.01.001.

以血性腹膜透析液为首发表现的外伤性延迟性脾破裂1例暨文献复习

A case report and literature review of the delayed traumatic splenic rupture with hemorrhagic ascites as the first manifestation

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