Presentation
Patient with a history of chronic lymphocytic leukemia (CLL) underwent a scheduled abdominal CT for restaging.
Patient Data
The images in non-contrast CT show an enlarged spleen. It seems that a subtle line of hypodensity is visible in the lower pole.
After contrast media, a narrow well-defined hypoattenuating area is shown in the lower third of the spleen. A subcapsular hematoma is present.
Subtle fluid is evident in the pouch of Douglas.
Case Discussion
This case illustrates a splenic rupture after a presumed minor trauma.
The patient with a history of chronic lymphocytic leukemia (CLL) has mentioned she fell down few days before the procedure.
There is evidence of splenomegaly, which can explain the rupture even if the trauma was only minor.
The patient due to her underlying pathology, the injury was considered as unstable and for this reason, the patient underwent surgical admission for monitoring and then splenectomy was the treatment of choice.
The patient is now in good health.