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©2010 Baishideng. All rights reserved.
World J Hepatol. Jun 27, 2010; 2(6): 243-245
Published online Jun 27, 2010. doi: 10.4254/wjh.v2.i6.243
Published online Jun 27, 2010. doi: 10.4254/wjh.v2.i6.243
Spontaneous splenic rupture during Pringle maneuver in liver surgery
Jesse M van Buijtenen, Department of Surgery, Westfriesgasthuis, PO Box 600, AR Hoorn Hoorn 1620, The Netherlands
Bas Lamme, Erik J Hesselink, Department of Surgery, Gelre Hospitals, Lukas, Apeldoorn 7300 DS, The Netherlands
Author contributions: van Buijtenen JM, Lamme B and Hesselink EJ contributed equally to this work.
Correspondence to: Erik J Hesselink, MD, PhD, Department of Surgery, Gelre Hospitals, Lukas, PO Box 9014 DS, Apeldoorn, The Netherlands. e.hesselink@gelre.nl
Telephone: +31-55-5818181 Fax: +31-55-5818131
Received: October 9, 2009
Revised: June 6, 2010
Accepted: June 13, 2010
Published online: June 27, 2010
Revised: June 6, 2010
Accepted: June 13, 2010
Published online: June 27, 2010
Abstract
During liver resection clamping of the hepato-duodenal ligament (the Pringle maneuver) is performed to reduce intraoperative blood-loss. During this maneuver acute portal hypertension may lead to spontaneous splenic rupture requiring rapid splenectomy in order to control blood loss. We present 2 case of patients with hemorrhage from the spleen during clamping for liver surgery. A review of the literature with an emphasis on the pathophysiology of splenic hemorrhage is presented.
Keywords: Spleen; Rupture; Pringle maneuver; Liver surgery