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Atraumatic splenic rupture: a case report
Jeremy Santarelli1, Rami Alattar1, Leslie R Elmore1
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
AME Case Reports
|October 9, 2024
Summary
Spontaneous splenic rupture, though rare, requires prompt diagnosis and treatment to prevent severe complications. This case highlights a true spontaneous splenic rupture in an elderly female, emphasizing the need for timely intervention.
Area of Science:
- Medicine
- Surgery
- Emergency Medicine
Background:
- Spontaneous splenic rupture is a rare clinical event, often linked to underlying hematologic, neoplastic, or infectious conditions.
- Infectious mononucleosis caused by Epstein-Barr virus is a common worldwide cause of spontaneous splenic rupture.
- True spontaneous splenic rupture without an identifiable underlying cause is considered exceedingly rare.
Observation:
- A 73-year-old female presented with acute left flank pain radiating to the shoulder.
- Computed tomography revealed an acute splenic injury with hemoperitoneum, indicating splenic rupture.
- The patient underwent emergent exploratory laparotomy and splenectomy.
Findings:
- The case describes a true spontaneous splenic rupture in an elderly female without a clear underlying cause.
- Prompt diagnosis and surgical intervention (splenectomy) were crucial for managing the splenic rupture.
- The patient recovered well following the splenectomy and received post-operative vaccinations.
Implications:
- Early diagnosis and treatment of atraumatic splenic rupture are critical due to high associated morbidity and mortality.
- Splenectomy remains the primary treatment for splenic rupture, alongside resuscitation.
- While non-operative management is reported for stable patients, its long-term outcomes are uncertain; spontaneous splenic rupture warrants urgent consideration in differential diagnoses.
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