Spontaneous rupture of the spleen secondary to amyloidosis

Rupture of the spleen has been classically associated with trauma. It sometimes is a spontaneous event or may be secondary to a pathological condition of the spleen or even in a healthy spleen. Systemic amyloidosis is characterized by the extracellular deposition of amyloid proteins in one or more organs. The spleen can be affected in 41% of patients. We undertook this study to present a case of spontaneous splenic rupture secondary to amyloid infiltration of the spleen, an uncommon condition in the literature.

We present the case of a 46-year-old male with abdominal pain, fever, abdominal distention and tachycardia. There were peritoneal signs during physical examination and leukocytosis was reported in the laboratory tests. The patient previously received analgesics and we suspected acute appendicitis modified by medications. It was decided to perform a laparotomy, finding hemoperitoneum as a consequence of spleen rupture. We performed splenectomy with a favorable patient outcome. Histopatological study reported amyloid infiltration of the spleen.

In patients with abdominal pain and hypotension, we should suspect the possibility of a spontaneous splenic rupture, even without trauma or infection.