{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T21:20:07Z","timestamp":1770412807243,"version":"3.49.0"},"reference-count":7,"publisher":"IMR Press","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Hosp Med"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:p>A 24-year-old woman, who was 8 weeks postpartum, presented to the surgical emergency unit with sudden onset of severe generalized abdominal pain. Apart from a previous ovarian cyst, there were no other significant past medical problems. She denied any recent abdominal trauma or strain.<\/jats:p>\n                  <jats:p>On examination, the patient had a very tender upper abdomen. Ultrasound scan demonstrated free fluid in both the abdomen and the pelvis. It also showed a large complex focal lesion in the spleen, close to the hilum, measuring 80\u00d776 mm (Figure 1). Conservative management was planned initially, but surgery was performed as the patient developed signs of generalized peritonitis along with severe pain in both shoulders. A diagnostic laparoscopy revealed massive haemoperitoneum and bleeding from the upper pole of the spleen (grade II splenic rupture). Haemostasis could not be achieved, and hence a splenectomy was performed via an upper midline laparotomy. The patient made an uneventful recovery. Appropriate vaccinations were given post splenectomy (Haemophilus influenzae, Neisseria meningitides and pneumococcus).<\/jats:p>\n                  <jats:p>On macroscopic examination, the spleen measured 160\u00d7120\u00d775 mm and weighed 342 g (Figure 2). Transverse section revealed a unilocular cyst of 85\u201390 mm in diameter containing haemorrhagic material. Histological examination revealed that the cyst was an epidermoid cyst and showed the presence of both old and new clots. Further additional history from the patient after splenectomy disclosed an admission to the medical ward 4 weeks after her delivery with left shoulder pain, left-sided chest pain and left-sided neck pain that was worse on movement and with cough. There was no history of trauma or fall. She was stable haemodynamically and all her haematological investigations were normal. She was treated as having musculoskeletal pain, given analgesics and was discharged home on the day of presentation. She had two further episodes of left shoulder pain that were treated similarly at a different hospital.<\/jats:p>","DOI":"10.12968\/hmed.2008.69.2.28357","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T09:45:15Z","timestamp":1400838315000},"page":"106-107","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous splenic rupture in the postpartum period"],"prefix":"10.31083","volume":"69","author":[{"given":"Sharath CV","family":"Paravastu","sequence":"first","affiliation":[{"name":"Surgery, Wrexham Maelor Hospital, Wrexham LL13 7TD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Burdge","sequence":"additional","affiliation":[{"name":"Wrexham Maelor Hospital, Wrexham LL13 7TD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"da Silva","sequence":"additional","affiliation":[{"name":"Wrexham Maelor Hospital, Wrexham LL13 7TD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","reference":[{"key":"p_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-198843030-00001"},{"key":"p_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2005.05.005"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(01)01178-4"},{"issue":"1","key":"p_4","first-page":"1","volume":"106","author":"Orloff MJ","year":"1958","journal-title":"Surg Gynecol Obstet"},{"issue":"3","key":"p_5","first-page":"233","volume":"31","author":"Senocak ME","year":"1989","journal-title":"Turk J Pediatr"},{"key":"p_6","first-page":"262","volume":"53","author":"Libson E","year":"1984","journal-title":"Diagn Imaging Clin Med"},{"key":"p_7","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/014107689809101017","volume":"91","author":"Yiangou C","year":"1998","journal-title":"J R Soc Med"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/hmed.2008.69.2.28357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:17:31Z","timestamp":1770373051000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/69\/2\/10.12968\/hmed.2008.69.2.28357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,2]]},"references-count":7,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2008,2]]}},"alternative-id":["10.12968\/hmed.2008.69.2.28357"],"URL":"https:\/\/doi.org\/10.12968\/hmed.2008.69.2.28357","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,2]]}}}