Related Experiment Video
Updated: May 3, 2026
Pseudofracture: An Acute Peripheral Tissue Trauma Model
Published on: April 18, 2011
Spontaneous splenic rupture due to infectious mononucleosis requiring splenectomy: clinical challenges and management
Ahmed Owies1, Ahmed Attia2, Patricia Cepeda2
1Intensive Care Unit, Epsom and Saint Helier Hospital NHS Trust, London, London, UK ahmed.oweis@nhs.net.
Abstract:
A male patient in his late teens initially presented with severe left upper abdominal pain, following a week of influenza-like symptoms. Initially, he presented to his GP, who diagnosed him with bacterial tonsillitis and treated him with clarithromycin. His clinical condition deteriorated further with severe vomiting and abdominal pain. Clinical assessment in accident and emergency revealed tachycardia, splenomegaly, lymphadenopathy and metabolic acidosis. Investigations confirmed Epstein-Barr virus infection, splenic rupture and haemoperitoneum, requiring an emergency splenectomy. He received blood transfusions due to a severe, sudden drop in his haemoglobin with haemodynamic instability.Postoperative management included admission to the intensive care unit sedated and intubated. He was in the intensive care unit for a few days before being extubated and stepped down to the ward. Follow-up included outpatient clinic visits and vaccinations against encapsulated organisms due to increased infection risks. The patient's recovery was uneventful, with no complications.
Insights
Epstein-Barr virus infection can lead to splenic rupture and internal bleeding in adolescents. Prompt diagnosis and emergency splenectomy are crucial for managing this rare but serious complication.
Area of Science:
- Infectious Diseases
- Pediatric Surgery
- Hematology
Background:
- Adolescents can present with non-specific symptoms mimicking common infections.
- Influenza-like symptoms can precede severe complications like splenic rupture.
- Early recognition of Epstein-Barr virus (EBV) infection is vital.
Purpose of the Study:
- To report a rare case of EBV-induced splenic rupture in an adolescent.
- To highlight the diagnostic challenges and management of this critical condition.
- To emphasize the importance of timely surgical intervention.
Main Methods:
- Clinical presentation of a teenage male with abdominal pain and influenza-like symptoms.
- Diagnostic workup including physical examination, laboratory tests, and imaging.
- Emergency surgical management via splenectomy due to splenic rupture and haemoperitoneum.
- Postoperative intensive care unit (ICU) management and follow-up care.
Main Results:
- Confirmed Epstein-Barr virus infection as the underlying cause.
- Diagnosed splenic rupture with significant haemoperitoneum and haemodynamic instability.
- Successful emergency splenectomy and subsequent recovery.
- Patient required blood transfusions and ICU admission post-surgery.
Conclusions:
- Splenic rupture is a rare but life-threatening complication of Epstein-Barr virus infection.
- Multidisciplinary approach involving infectious disease, surgery, and critical care is essential.
- Adolescents with persistent abdominal pain and signs of systemic illness require thorough investigation for EBV.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...