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A MISSED SPONTANEOUS SPLENIC RUPTURE IN A NIGERIAN NEONATE - A RARE AND CHALLENGING CASE REPORT AND REVIEW OF
K I Egbuchulem1, M M Awodiji2, D Efe3
1Division of Paediatric Surgery, Department of Surgery, University College Hospital, Ibadan.
Annals of Ibadan Postgraduate Medicine
|March 25, 2026
Summary
Neonatal splenic rupture, a rare but fatal condition, can result from birth trauma or increased abdominal pressure. Early diagnosis and intervention are crucial for improving outcomes in newborns presenting with abdominal distension and shock.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Radiology
Background:
- Splenic rupture is an uncommon neonatal emergency, often linked to birth trauma or conditions causing increased intra-abdominal pressure like polyhydramnios and fetal ascites.
- Abdominal ultrasonography is the primary diagnostic tool for suspected splenic injury in neonates.
- This case represents a rare occurrence of neonatal splenic rupture reported from sub-Saharan Africa.
Purpose of the Study:
- To report a rare case of neonatal splenic rupture.
- To increase awareness of this potentially fatal condition among healthcare providers.
- To emphasize the importance of a high index of suspicion for neonatal splenic rupture.
Main Methods:
- A case report of a 2-day-old male neonate presenting with abdominal distension and respiratory distress after elective Cesarean section.
- Diagnostic workup included serial packed cell volume measurements and abdominal ultrasonography.
- Surgical management involved exploratory laparotomy to identify and control splenic laceration.
Main Results:
- The neonate presented with significant hemodynamic instability (PCV drop from 40% to 23%) and hepatosplenomegaly with ascites.
- Intraoperative findings revealed a 3cm subcapsular splenic laceration with hemoperitoneum.
- Despite surgical intervention, the neonate experienced a cardiopulmonary arrest and could not be resuscitated.
Conclusions:
- Neonatal splenic rupture, though rare, carries a high mortality rate, particularly with delayed diagnosis and treatment.
- Prompt recognition and appropriate management, whether non-operative or surgical, are critical.
- A high index of suspicion is essential for all neonates presenting with concerning abdominal findings.
