Spontaneous splenic hemorrhage in a patient with Wegener's granulomatosis

We report the occurrence of spontaneous splenic hemorrhage in a patient with Wegener's granulomatosis. Pulmonary infiltrates, hemoptysis, and crescentic glomerulonephritis were accompanied by a progressive splenic enlargement with minimal abdominal symptoms. Magnetic resonance imaging was particularly helpful. The spleen was removed by minimally invasive endoscopic surgery. Subcapsular hemorrhage had occurred because of splenic vasculitis. Postoperatively, a remission was achieved by a combination of high-dose corticosteroids and cyclophosphamide.