Splenic artery pseudoaneurysm due to seatbelt injury in a glucose-6-phosphate dehydrogenase-deficient adult

Singapore Med J. 2013 Nov;54(11):e230-2. doi: 10.11622/smedj.2013189.

Abstract

A 23-year-old man presented with abdominal pain after suffering blunt trauma caused by a seatbelt injury. His low platelet count of 137 × 10(9)/L was initially attributed to trauma and his underlying hypersplenism due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Despite conservative management, his platelet count remained persistently reduced even after his haemoglobin and clotting abnormalities were stabilised. After a week, follow-up imaging revealed an incidental finding of a pseudoaneurysm (measuring 9 mm × 8 mm × 10 mm) adjacent to a splenic laceration. The pseudoaneurysm was successfully closed via transcatheter glue embolisation; 20% of the spleen was also embolised. A week later, the platelet count normalised, and the patient was subsequently discharged. This case highlights the pitfalls in the detection of a delayed occurrence of splenic artery pseudoaneurysm after blunt injury via routine delayed phase computed tomography. While splenomegaly in G6PD may be a predisposing factor for injury, a low platelet count should arouse suspicion of internal haemorrhage rather than hypersplenism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Accidents, Traffic
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology*
  • Aneurysm, False / therapy
  • Embolization, Therapeutic / methods
  • Follow-Up Studies
  • Glucosephosphate Dehydrogenase Deficiency / complications
  • Glucosephosphate Dehydrogenase Deficiency / diagnosis*
  • Humans
  • Injury Severity Score
  • Male
  • Rare Diseases
  • Risk Assessment
  • Seat Belts / adverse effects*
  • Splenic Artery / injuries*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / diagnosis*
  • Young Adult