Spontaneous (atraumatic) splenic rupture
Woke up with sudden severe LUQ pain, no trauma. Recently unwell with "cold"
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Spleen is minimally enlarged but associated with a large volume perisplenic hematoma (sentinel clot) containing contrast extravasation indicative of active bleeding at the time of the scan, as well as liquid hemoperitoneum around the liver.
The is a case of spontaneous splenic rupture seen usually in younger people with an underlying viral illness as as CMV or infectious mononucleosis. It can be fatal. The spleens in these cases are often not markedly enlarged but presumably "soft" as a result of the infection allowing for easy rupture.
- Maria V, Saad AM, Fardellas I. Spontaneous spleen rupture in a teenager: an uncommon cause of acute abdomen. Case Rep Med. 2013;2013: 675372. doi:10.1155/2013/675372