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Spontaneous splenic rupture in infectious mononucleosis: sonographic diagnosis and follow-up
Abstract:
Spontaneous rupture of the spleen occurs as a serious but relatively infrequent complication of infectious mononucleosis. Over 100 such cases have been reported. In all but one of the cases previously reported, diagnosis of splenic rupture was made at laparotomy. Three new cases are reported where the diagnosis of splenic rupture was made using sonography. The patients were followed by sonography and none required laparotomy. Aspiration of the hematoma under sonographic control confirms the diagnosis and may be curative.
Insights
Spontaneous splenic rupture, a rare infectious mononucleosis complication, can now be diagnosed non-surgically. Ultrasound (sonography) allows for accurate diagnosis and potentially curative hematoma aspiration, avoiding invasive laparotomy.
Area of Science:
- Internal Medicine
- Radiology
- Surgical Complications
Background:
- Spontaneous splenic rupture is a rare but serious complication of infectious mononucleosis.
- Historically, diagnosis required exploratory laparotomy, an invasive surgical procedure.
- Over 100 cases of splenic rupture associated with mononucleosis have been documented.
Observation:
- Three new cases of splenic rupture secondary to infectious mononucleosis are presented.
- Diagnosis was achieved non-invasively using ultrasound (sonography).
- Patients were monitored via sonography, and none necessitated surgical intervention.
Findings:
- Sonography provides accurate diagnosis of splenic rupture.
- Ultrasound-guided aspiration of splenic hematomas can be curative.
- Non-operative management of splenic rupture is feasible in select cases.
Implications:
- Ultrasound offers a less invasive diagnostic and potentially therapeutic approach for splenic rupture in infectious mononucleosis.
- This approach may reduce the need for exploratory laparotomy, minimizing patient risk and recovery time.
- Further research into non-operative management strategies for splenic complications is warranted.