Atraumatic idiopathic splenic rupture induced by granulocyte-colony stimulating factor (G-CSF) for the treatment of pancytopenia, managed successfully by laparoscopic splenectomy

BMJ Case Rep. 2020 Apr 9;13(4):e232411. doi: 10.1136/bcr-2019-232411.

Abstract

Splenic rupture is a potentially life-threatening condition and an uncommon short-term complication of granulocyte-colony stimulating factor (G-CSF) administration. It may present as acute abdominal pain or suddenly precipitously worsening anaemia with haemodynamic instability that requires urgent operative intervention for survival. We present a case of an atraumatic idiopathic splenic rupture in University Hospital, Ayr in a patient who received G-CSF treatment for chemotherapy-induced (methotrexate) pancytopenia and was successfully managed by laparoscopic splenectomy.

Keywords: gastrointestinal surgery; general surgery; haematology (incl blood transfusion).

Publication types

  • Case Reports

MeSH terms

  • Female
  • Granulocyte Colony-Stimulating Factor / adverse effects*
  • Humans
  • Laparoscopy
  • Middle Aged
  • Pancytopenia / drug therapy
  • Rupture, Spontaneous / etiology*
  • Rupture, Spontaneous / surgery
  • Spleen / diagnostic imaging
  • Splenectomy
  • Splenic Rupture / etiology*
  • Splenic Rupture / surgery
  • Treatment Outcome
  • United Kingdom / epidemiology

Substances

  • Granulocyte Colony-Stimulating Factor