Splenic rupture by tubular drain in a patient with necrotizing pancreatitis: Case report and review

Background: Severe acute pancreatitis is an acute abdominal disease that possesses a powerful systemic inflammatory response, and can progress quickly, going from the stage of local pancreatic damages to the dysfunction of several organs, with the development of multiple local and systemic complications. Aim: In this article, a case of splenic perforation by abdominal drain will be described, as a late complication of pancreatic necrosectomy, in a patient with severe acute pancreatitis. Methods: The information was obtained through data from medical records and photographic registers of the diagnosed methods to which the patient has been submitted, andrevision of medical literature. Results: F.L.S, female, 54 years old, hospitalized at Health House São Lucas Hospital presenting intense abdominal pain and elevation of pancreatic enzymes. During the hospitalization, the patient developed a sepsis and a new abdominal CT scan showed necrosis covering more than 70% of the pancreas, associated with the infection of the mentioned necrosis. Following the pancreatic necrosectomy by placement of abdominal drains, the patient presented a splenic perforation by the tubular abdominal drain, resulting in the necessity to adopt conservatory measures to deal with this case. Conclusion: Therefore, it is possible to observe that there hasn´t been any reports of splenic perforation by draining following a pancreatic necrosectomy in the medical literature consulted. Thus, this report constitutes a rare case to the present day. However, there is no way to contraindicate the frequent use of tubular draining, since this is an isolated case and there isn´t other data and there aren´t reports that analyses this topic in medical literature.