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Marked Congenital Fissure Masquerading as Splenic Laceration: Report of a Case

St. Luke's Hospital and The Medical College of Wisconsin, Milwaukee, Wisconsin

Correspondence: For reprints contact: Richard M. Hansen, MD, Milwaukee County Medical Complex, 8700 W. Wisconsin Ave., Milwaukee, WI 53226.

ABSTRACT

A 26-year-old white woman fell from a ladder striking her back. Clinical evaluation indicated a left renal contusion with microscopic hematuria, and a liver-spleen scan suggested a splenic laceration. The patient was in initially stable but evidence of ongoing blood loss forced exploratory laparotomy on the third hospital day. A large, retroperitoneal perirenal hematoma was found but the spleen was intact, with multiple marked congenital fissures. The problem of congenital fissures as a cause of abnormal spleen scan is discussed.