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November 1973, Vol 126, No. 5 >
Article | November 1973

Splenic Rupture in Neonates With Erythroblastosis Fetalis FREE

Michael A. Simmons, MD; John D. Burrington, MD; Eli R. Wayne, MD; William E. Hathaway, MD
[+] Author Affiliations

Received for publication April 25, 1973; accepted June 8.

Reprint requests to Department of Pediatrics, University of Colorado Medical Center, 4200 E Ninth Ave, Denver 80220 (Dr. Simmons).


Am J Dis Child. 1973;126(5):679-681. doi:10.1001/archpedi.1973.02110190547018.
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Two neonates with erythroblastosis fetalis developed significant hemorrhage from splenic tears. Each infant had received several exchange transfusions with heparinized blood before developing marked abdominal distention, a rapidly falling hematocrit reading, and signs of cardiovascular collapse. Paracentesis in each case confirmed the presence of intra-abdominal bleeding and preoperative coagulation studies revealed decreased levels of multiple clotting factors and platelets. The underlying hemostatic abnormality in each infant was further complicated by our failure to neutralize the heparin used in the exchange transfusions. Both infants were successfully treated by preoperative replacement of specific clotting factors and a conservative surgical approach not requiring splenectomy.

REFERENCES

1 +
Bourjola JM, Aubrespy P:  Spontaneous peritoneal hemorrhage of splenic origin in newborn infants . Ann Chir Infant 7:49-54, 1966;.
2 +
Delta BG, Eisenstein EM, Rothenberg AM:  Rupture of normal spleen in the newborn: Report of a survival and review of the literature . Clin Pediatr 7:373-376, 1968;.
3 +
Myers NA:  Ruptured spleen: A manifestation of birth injury . Med J Aust 49:809-810, 1962;.
4 +
O'Neill EA, O'Brian RE, Hyum BH:  Rupture of the spleen in the newborn infant: Report of a survival . JAMA 193:959-960, 1965;.
5 +
Parenti GC, Ciardini A:  Rupture of the spleen in a newborn . Riv Chir Pediatr 8:511-516, 1966;.
6 +
Schwartz O, Cohen BD:  Rupture of the normal spleen in the newborn, with survival . Surgery 59:1124-1127, 1966;.
7 +
Volosky EM, Veloso AN:  Rupturia obstetrica del bozo en el recien nacido . Rev Chir Pediatr 41:443-446, 1970;.
8 +
Gruenwald PG:  Rupture of the liver and spleen in the newborn infant . J Pediatr 33:195-201, 1948;.
9 +
Eraklis AJ, Filler RM:  Splenectomy in childhood: A review of 1,413 cases . J Pediatr Surg 7:382-388, 1972;.
10 +
Phillipsborn HF, Traisman HS, Greer D: Rupture of the spleen:  A complication of erythroblastosis fetalis . N Engl J Med 252:159-162, 1965;.
11 +
Slotkowski EL, Hand AM:  Rupture of spleen in erythroblastotic infants . Pediatrics 4:296-300, 1949;.
12 +
Fenton L, Bove KE:  Delayed anemia in a newborn infant . J Pediatr 80:515-523, 1972;.
13 +
Sirola K:  Subcapsular bleeding of the spleen with rupture in a newborn infant with erythroblastosis fetalis . J Pediatr Surg 2:155-157, 1967;.
14 +
Giedion A:  Die geburtstraumatische ruptur parenchymatoser bauchorgane mit massivem blutverlust und ihre radiologische darstellung . Helv Paediatr Act 18:349-370, 1963;.
15 +
Sieber WK, Girdany BR:  Rupture of the spleen in newborn infants: Recovery with splenectomy . N Engl J Med 259:1074-1076, 1958;.
16 +
Hathaway WE:  Coagulation problems in the newborn infant . Pediatr Clin North Am 17:929-942, 1970;.
17 +
Chessels JM, Wigglesworth JS:  Haemostatic failure in babies with Rhesus isoimmunization . Arch Dis Child 46:38-45, 1971;.
18 +
Finland M:  Serious infections in splenectomized children . Pediatrics 27:689-691, 1961;.
19 +
Eraklis AJ, et al:  Hazard of overwhelming infection after splenectomy in childhood . N Engl J Med 276:1225-1229, 1967;.
20 +
Searcy RC, Simms NM, Low EM:  A simple method for the rapid detection of hypofibrinogenemia . Am J Med Tech 33:326-329, 1967;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Bourjola JM, Aubrespy P:  Spontaneous peritoneal hemorrhage of splenic origin in newborn infants . Ann Chir Infant 7:49-54, 1966;.
2 +
Delta BG, Eisenstein EM, Rothenberg AM:  Rupture of normal spleen in the newborn: Report of a survival and review of the literature . Clin Pediatr 7:373-376, 1968;.
3 +
Myers NA:  Ruptured spleen: A manifestation of birth injury . Med J Aust 49:809-810, 1962;.
4 +
O'Neill EA, O'Brian RE, Hyum BH:  Rupture of the spleen in the newborn infant: Report of a survival . JAMA 193:959-960, 1965;.
5 +
Parenti GC, Ciardini A:  Rupture of the spleen in a newborn . Riv Chir Pediatr 8:511-516, 1966;.
6 +
Schwartz O, Cohen BD:  Rupture of the normal spleen in the newborn, with survival . Surgery 59:1124-1127, 1966;.
7 +
Volosky EM, Veloso AN:  Rupturia obstetrica del bozo en el recien nacido . Rev Chir Pediatr 41:443-446, 1970;.
8 +
Gruenwald PG:  Rupture of the liver and spleen in the newborn infant . J Pediatr 33:195-201, 1948;.
9 +
Eraklis AJ, Filler RM:  Splenectomy in childhood: A review of 1,413 cases . J Pediatr Surg 7:382-388, 1972;.
10 +
Phillipsborn HF, Traisman HS, Greer D: Rupture of the spleen:  A complication of erythroblastosis fetalis . N Engl J Med 252:159-162, 1965;.
11 +
Slotkowski EL, Hand AM:  Rupture of spleen in erythroblastotic infants . Pediatrics 4:296-300, 1949;.
12 +
Fenton L, Bove KE:  Delayed anemia in a newborn infant . J Pediatr 80:515-523, 1972;.
13 +
Sirola K:  Subcapsular bleeding of the spleen with rupture in a newborn infant with erythroblastosis fetalis . J Pediatr Surg 2:155-157, 1967;.
14 +
Giedion A:  Die geburtstraumatische ruptur parenchymatoser bauchorgane mit massivem blutverlust und ihre radiologische darstellung . Helv Paediatr Act 18:349-370, 1963;.
15 +
Sieber WK, Girdany BR:  Rupture of the spleen in newborn infants: Recovery with splenectomy . N Engl J Med 259:1074-1076, 1958;.
16 +
Hathaway WE:  Coagulation problems in the newborn infant . Pediatr Clin North Am 17:929-942, 1970;.
17 +
Chessels JM, Wigglesworth JS:  Haemostatic failure in babies with Rhesus isoimmunization . Arch Dis Child 46:38-45, 1971;.
18 +
Finland M:  Serious infections in splenectomized children . Pediatrics 27:689-691, 1961;.
19 +
Eraklis AJ, et al:  Hazard of overwhelming infection after splenectomy in childhood . N Engl J Med 276:1225-1229, 1967;.
20 +
Searcy RC, Simms NM, Low EM:  A simple method for the rapid detection of hypofibrinogenemia . Am J Med Tech 33:326-329, 1967;.

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