Spontaneous (atraumatic) splenic rupture

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Woke up with sudden severe LUQ pain, no history of trauma. Recently unwell with "cold".

Patient Data

Age: 20 years
Gender: Male
  • Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

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.

Case Discussion

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.

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