A spontaneous splenic rupture secondary to Epstein Barr Virus infection: a case report

Atraumatic Splenic Rupture (ASR) is a very rare and potentially life-threatening event associated with Epstein Barr Virus (EBV)-induced mononucleosis; it occurs in <0.5% of overall cases. The aim of the present study was to publish a case report of the ASR and to present a mini review of the international literature.

A 22-year-old female presented to emergency department with abdominal pain, nausea and vomiting. The patient's medical history was unremarkable, and she denied trauma. On arrival, her vital signs were stable. However, laboratory examinations showed haemoglobin values of 7.8 g/dl, lymphocytosis and elevated liver function tests. Abdomen Computed Tomography (CT) scan highlighted haemoperitoneum and splenic hematoma. Angiography and embolization of active bleeding followed by emergency laparoscopic splenectomy were performed.

In patients without a history of trauma, spontaneous splenic rupture should be considered in the differential diagnosis if patients have abdominal and left shoulder tip pain, and laboratory results indicate low haemoglobin level. There is no consensus on treatment management on ASR.

This case underlines the importance of considering splenic rupture as a complication of EBV infection. Moreover, endovascular techniques and laparoscopic management can be considered to ensure a minimally invasive approach and improve outcomes.