%0 Journal Article
%T Unusual case of pancreatic inflammatory myofibroblastic tumor associated with spontaneous splenic rupture
%A Kamal S Hassan
%A Hector I Cohen
%A Fadi K Hassan
%A Shadi K Hassan
%J World Journal of Emergency Surgery
%D 2010
%I BioMed Central
%R 10.1186/1749-7922-5-28
%X A 19 years old male patient with no significant past medical history presented to emergency room with abdominal pain and fatigue. Massively enlarged spleen was detected. Hypotension and rapid reduction of hemoglobin level necessitated urgent laparatomy. About 1.75 liters of blood were found in abdominal cavity. A large tumor arising from the tail of pancreas and local rupture of an enlarged spleen adjacent to the tumor were detected. Distal pancreatectomy and splenectomy were performed. To our knowledge, we report the first case of massively enlarged spleen that was complicated with spontaneous splenic rupture as a result of splenic congestion due to mechanical obstruction caused by an inflammatory myofibroblastic tumor of the tail of pancreas. A review of the literature is also presented.Inflammatory myofibroblastic tumor of the tail of pancreas should be included in the differential diagnosis of the etiological causes of massively enlarged spleen and spontaneous splenic rupture.The most common causes of splenomegaly are liver diseases (33%), hematologic malignancies (27%), infections (23%), congestion or inflammation (8%), primary splenic diseases (4%) and others (5%) [1]. Cirrhosis, lymphoma, AIDS and endocarditis, congestive heart failure and splenic vein thrombosis considered the most common causes in each variety - respectively [1]. There are only a few conditions that cause massively enlarged spleen including chronic myeloid leukemia, hairy cell leukemia, lymphoma, myelofibrosis, thalassemia major, visceral leishmaniasis, malaria, tropical splenomegaly syndrome, AIDS with Mycobacterium avium complex and Gaucher disease [2]. Spontaneous splenic rupture considered a relatively rare but life threatening. Recently, Renzulli et al reported a systematic review of 845 cases with spontaneous splenic rupture that had been published over more than 28 years [3]. In 84.1 percent of cases a single etiological factor was found. Two underlying pathologies were found in 8.2
%U http://www.wjes.org/content/5/1/28