Fact-sheet: Spontaneous splenic rupture
Updated on 09/04/2020 at 2:17 PM
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Definition
Spontaneous splenic rupture most often occurring in the setting of infection:
- infectious mononucleosis (EBV - rare but serious complication: leading cause of mortality),
- more rarely: malaria, dengue fever (context, travel history), embolic splenic infarction, acute myeloid leukemia, lupus, splenic amyloidosis...
Clinical features
Possible signs of shock.
Left upper quadrant pain that may radiate to the shoulder (Kehr's sign).
Laboratory findings
Serologic diagnosis for infectious mononucleosis.
- Anemia, leukocytosis, elevated CRP, abnormal liver function tests...
Ultrasound
Splenomegaly, large hemoperitoneum
CT
- Possible splenomegaly
- Hemoperitoneum with perisplenic sentinel clot
- Possible active bleeding
Management
- Conservative management: clinical, laboratory, and CT follow-up
- Interventional radiology embolization in case of active arterial bleeding
- Splenectomy for hemostasis