Urgent Laparoscopic Splenectomy After Traumatic Splenic Rupture in Pregnancy

Laparoscopic splenectomy is accepted as a gold standard in the treatment of different hematologic diseases, but there are only sporadic reports about its use in the trauma patients. We report here the case of the urgent laparoscopic splenectomy performed in pregnant patient who sustained blunt abdominal trauma, with grade V of splenic injury. In the position of supination, diagnostic laparoscopy revealed the presence of a large amount of free fluid in the abdomen, and a lesion onhilum of spleen. After mobilization of the spleen, en masse transection of the splenic pedicle was done with vascular stapler, and the spleen was removed by endobag through the expanding one of the ports. Patient had an uneventful recovery and was discharged on the eight postoperative day, with no discernible effects on the course of the pregnancy. This case shows that laparoscopic splenectomy in ruptured spleen is feasible and a safe procedure, even in pregnant patients who sustained a blunt abdominal trauma, but it requires adequate experience in laparoscopic surgery and elective laparoscopic splenectomy.