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Spontaneous splenic rupture is rare, but can be triggered by minor events. This case reports the first instance of splenic rupture following direct current cardioversion (DCCV) due to abdominal muscle contractions.

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Area of Science:

  • Cardiology
  • Gastroenterology
  • Trauma Surgery

Background:

  • Atraumatic splenic rupture is uncommon, with minor physical events often cited as triggers.
  • Patients with eosinophilic pneumonia may experience cardiac complications requiring intervention.

Observation:

  • A 65-year-old man underwent direct current cardioversion (DCCV) for atrial flutter.
  • Post-cardioversion, he presented with acute abdomen and signs of intraperitoneal hemorrhage.
  • Bedside ultrasonography confirmed free intraperitoneal fluid, leading to exploratory laparotomy.

Findings:

  • Splenic rupture was identified during laparotomy, necessitating a splenectomy.
  • Histological examination revealed splenic rupture without other splenic abnormalities.
  • The rupture was attributed to the forceful abdominal muscle contractions during DCCV.

Implications:

  • This case highlights a potential, previously unreported complication of DCCV.
  • Clinicians should consider splenic injury in patients presenting with acute abdomen post-cardioversion.
  • Further investigation may be warranted to understand the mechanism and incidence of DCCV-induced splenic rupture.