Spontaneous splenic infarcts and rupture presenting as massive haemoperitoneum

Abstract

Spontaneous rupture of a normal spleen without a history of an evident blunt abdominal trauma is a rare clinical entity and can occur in both histologically normal and diseased spleen. Non-traumatic spontaneous splenic rupture (NSSR) has a high morbidity, as there is often little or no clinical history to suggest its presence, and it is vital that physicians consider this diagnosis when evaluating patients with abdominal pain and hypotension. We present a case of 32–years–old male who presented to Accident and Emergency Department with history of abdominal pain, vomiting and diarrhea, there was no history of trauma. Examination revealed initial hypotension, epigastric abdominal tenderness, and no palpable masses. An-abdominal ultrasound revealed massive free fluid and splenic hematoma; an emergency splenectomy was performed successfully. The patient recovered uneventfully and was discharged from the hospital. This case report has taught as that spontaneous rupture of a normal spleen can occur in a patient with negative results of malaria peripheral blood smear and antigen for P. Vivax and P. falciparum. Physicians should consider the diagnosis of spontaneous spleen rupture in a patient presenting with abdominal pain and hypotension even without a history of trauma; because an early intervention can be life-saving.