Systemic Lupus Erythematosus Complicated by Spontaneous Splenic Rupture.
Li Wang, Qianyu Zhou, Feng Liu, Peng Chen, Mingdao Hu, Haixia Tan
Abstract
Open AccessSpontaneous splenic rupture (SSR) is an uncommon but life-threatening surgical emergency. When it occurs as a complication of systemic lupus erythematosus (SLE), the diagnostic and therapeutic strategy becomes particularly complex. Published literature on SSR in the setting of SLE is sparse, and there is no clear consensus on the optimal management of such a surgical catastrophe. What is the optimal treatment strategy for patients with SSR complicated by SLE? This paper addresses these questions by providing an in-depth analysis of a representative case of SLE complicated by SSR that we successfully diagnosed and treated. Our case study details the patient's entire clinical course, from the initial presentation with non-specific abdominal pain, through confirmation via imaging diagnostics, to the final recovery achieved through a personalized treatment plan developed by a multidisciplinary team (MDT). A key finding of our research is the emphasis that, for patients with known autoimmune diseases such as SLE, the acute onset of abdominal pain, hemodynamic instability, or any signs of intra-abdominal bleeding should prompt clinicians to maintain a high index of suspicion and include SSR in the differential diagnosis. Rapid identification, multidisciplinary collaboration (involving close coordination among rheumatology, critical care, surgery, and radiology), and individualized treatment decisions based on the patient's specific condition are the cornerstones of successfully managing this severe complication and improving patient outcomes. We believe the significance of our findings lies in their potential to greatly enhance clinicians' understanding of this rare yet fatal complication of SLE. The detailed diagnostic and therapeutic pathway and the decision-making rationale provided in this report can serve as a valuable reference guide for colleagues worldwide when faced with similar challenging cases, potentially saving more patients' lives.