Abstract：
Hematopoietic hormones such as granulocyte-colony stimulating factors are commonly used prevent neutropenia in patients undergoing chemotherapy and to prepare patients for bone marrow donations. In rare cases, splenic injury can result from exposure to this medication. We present the case of a 30-year-old man who presented to the emergency department the day after a bone marrow donation procedure complaining of severe, acute onset left upper quadrant abdominal pain, radiating to the shoulder. Neither the patient nor his family reported any abdominal trauma prior to or following the marrow donation procedure. An initial bedside ultrasound examination was positive for peritoneal fluid and distortion of the normal splenic architecture, raising suspicion for possible intraabdominal or splenic injury. An emergent confirmatory CT with contrast of the abdomen confirmed the initial ultrasound examination suspicion of an atraumatic splenic rupture and with evidence of venous bleeding but without active arterial extravasation. An emergent trauma surgery consultation was placed, and he underwent embolization with an uneventful recovery. This case report highlights the need for a high index of suspicion for atraumatic splenic rupture in patients exposed to these types of granulocyte-colony stimulating factors.
摘要：
造血激素，如粒细胞集落刺激因子，通常用于预防接受化疗的患者的中性粒细胞减少症，并为患者的骨髓捐献做好准备。在极少数情况下,暴露于这种药物可能会导致脾损伤。我们介绍了一名30岁男子的案例，该男子在进行骨髓捐赠程序后的第二天向急诊科就诊，抱怨严重，急性发作左上腹腹痛，辐射到肩膀。患者及其家人在进行骨髓捐赠程序之前或之后均未报告任何腹部创伤。最初的床旁超声检查对腹膜液和正常脾结构的扭曲呈阳性，怀疑可能的腹内或脾损伤。腹部造影的紧急确诊CT证实了最初的超声检查怀疑无创伤脾破裂，并有静脉出血的证据，但没有活动性动脉外渗。紧急创伤手术会诊，他接受了栓塞治疗，恢复顺利。此病例报告强调，暴露于这些类型的粒细胞集落刺激因子的患者需要高度怀疑无创伤脾破裂。
