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La Presse Médicale
Vol 34, N° 22-C1  - décembre 2005
pp. 1717-1718
Doi : PM-12-2005-34-22-C1-0755-4982-101019-200509466
Cas clinique

Hématome spontané de la rate : traumatisme et/ou médicament ?
 

J.-C. Chakarian [1], F. Héron [1], C. Belizna [1], F. Hervé [1], J.-H. Maillochaud [2], I. Marie [1], H. Lévesque [1]
[1] Département de médecine interne, CHU Rouen-Boisguillaume, Rouen (76)
[2] Clinique de L’Europe, Boulevard de l’Europe, Rouen (76)

Tirés à part : Hervé Lévesque

[3] , Département de médecine interne, CHU Rouen-Boisguillaume, 76031 Rouen Cedex Tél. : 02 32 88 90 03 Fax : 02 32 88 90 26 herve.levesque@chu-rouen.fr

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Introduction Les hématomes spontanés de la rate sont rares et révèlent souvent une pathologie sous-jacente, notamment infectieuse, tumorale ou hématologique. La symptomatologie est habituellement aiguë, mais des formes progressives sont possibles.

Observation Chez un homme de 45 ans, un hématome splénique a été découvert dans le cadre du bilan étiologique d’un syndrome douloureux abdominal d’apparition récente. L’absence de facteur favorisant autre qu’un traumatisme minime 9 mois auparavant ou de maladie évolutive associée incite à s’interroger sur le rôle favorisant d’un traitement prolongé par un inhibiteur sélectif de recapture de la sérotonine (venlafaxine).

Discussion Si, en dépit du délai, le rôle du traumatisme semble pouvoir être retenu, il est vraisemblable que le traitement par inhibiteur de la recapture de la sérotonine a pu être un facteur favorisant.

Abstract
Spontaneous splenic hematoma: trauma injury or drug reaction or both?

Introduction Spontaneous splenic hematomas are uncommon and frequently associated with infectious, hematologic, or neoplastic diseases. Presentation is typically acute but progressive forms have been described.

Case We report the case of a 45-year-old man consulting for abdominal pain that was found to be due to a spontaneous splenic hematoma. No recent injuries, infections, or hematologic, neoplastic or gastrointestinal diseases were found, but the patient had had a minor injury 9 months earlier and had been treated with selective serotonin reuptake inhibitors (venlafaxine) for the past year. This history suggested that the drug might play a role.

Discussion Although the likely cause of this splenic hematoma appears to be a minor injury 9 months before the onset of pain, we cannot rule out the possibility that selective serotonin reuptake inhibitor treatment was a predisposing factor.






© 2005 Elsevier Masson SAS. Tous droits réservés.
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