warfarin and Splenic-Rupture

Splenic rupture is a life-threatening condition characterized by internal hemorrhage, often difficult to diagnose. Colonoscopy is a gold standard routine diagnostic test to investigate patients with gastrointestinal symptoms as well as to those on the screening program for colorectal cancer. Splenic injury is seldomly discussed during consent for colonoscopy, as opposed to colonic perforation, as its prevalence accounts for less than 0.1%. A 66-year-old Caucasian woman with no history of collagen disorder was electively admitted for routine colonoscopy for surveillance of adenoma. She was admitted following the procedure for re-dosing of warfarin, which was stopped prior to the colonoscopy. The patient was found collapsed on the ward the following day with clinical shock and anemia. Computed tomography demonstrated grade 4 splenic rupture. Immediate blood transfusion and splenectomy was required. Splenic rupture following routine colonoscopy is extremely rare. Awareness of it on this occasion saved the patient's life. Despite it being a rare association, the seriousness warrants inclusion in all information leaflets concerning colonoscopy and during its consent.

Topics: Abdominal Pain; Aged; Anticoagulants; Colonoscopy; Female; Humans; Splenic Rupture; Tomography, X-Ray Computed; Warfarin

Topics: Aged; Antineoplastic Agents; Female; Humans; Lymph Node Excision; Neoadjuvant Therapy; Ovarian Neoplasms; Rupture, Spontaneous; Salpingo-oophorectomy; Shock, Hemorrhagic; Splenic Rupture; Venous Thrombosis; Warfarin

Topics: Anticoagulants; Colonoscopy; Hemorrhage; Humans; Splenic Diseases; Splenic Rupture; Warfarin

Although there are many reports describing spontaneous rupture of either the spleen or the liver, the simultaneous rupture of both organs is a rare event, especially during anticoagulant therapy. We report a case of spontaneous rupture of the spleen and liver in a patient on warfarin therapy for deep venous thrombosis.

Topics: Adult; Chemical and Drug Induced Liver Injury; Follow-Up Studies; Hepatectomy; Humans; Liver Diseases; Male; Risk Assessment; Rupture, Spontaneous; Splenectomy; Splenic Rupture; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler; Venous Thrombosis; Warfarin

Non-traumatic (spontaneous) rupture of the spleen is a rare condition. Predisposing factors such as haematological disease, malignant tumour, inflammatory disease, infection, connective tissue disease and miscellaneous disorders have been reported. This report describes two patients with ruptured spleens, one of whom used warfarin, the other had a ruptured haemangioma.

Topics: Aged; Female; Hemangioma; Humans; Male; Rupture, Spontaneous; Splenic Neoplasms; Splenic Rupture; Warfarin

A 44-year-old man, who had been taking warfarin sodium because of a previous myocardial infarct, suddenly developed abdominal pain and signs of peritoneal irritation, requiring exploratory laparotomy. The spleen was ruptured. There were not any systemic diseases nor antecedents of trauma that could be considered predisposing factors for the apparently spontaneous rupture of the spleen. The only abnormality recorded was an elevated prothrombin time. Thus, a coagulopathy produced by the anticoagulants appeared to be the only possible predisposing factor for his splenic rupture.

Topics: Adult; Humans; Male; Myocardial Infarction; Prothrombin Time; Splenic Rupture; Warfarin