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Splenic rupture and infectious mononucleosis.
1Department of Surgery, Conemaugh Valley Memorial Hospital, Johnstown, Pennsylvania.
The Journal of Emergency Medicine
|September 1, 1989
Summary
Infectious mononucleosis can cause spleen rupture, a rare but serious complication. Prompt diagnosis and treatment, often splenectomy, are crucial due to potential high mortality without trauma history.
Area of Science:
- Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Infectious mononucleosis frequently causes splenomegaly.
- Splenic rupture is a rare but life-threatening complication of infectious mononucleosis.
Observation:
- Patients with spontaneous splenic rupture often present with epigastric or upper abdominal pain.
- Diagnostic methods include CT scan, ultrasound, radionuclide scan, and peritoneal lavage.
- Selective splenic angiography is accurate but rarely used due to invasiveness.
Findings:
- Histopathologic changes in the spleen increase vulnerability to injury.
- Mortality is significant in cases of splenic rupture, often without a history of trauma.
Implications:
- Splenectomy remains the primary treatment for splenic rupture.
- Conservative management (nonoperative therapy or splenorrhaphy) is being explored for stable patients.
- Caution is advised with conservative approaches due to the spleen's altered histology.