Spontaneous rupture of the spleen

Case Report

Abstract

Introduction : Non-traumatic ruptures can be fatal, the diagnosis is sometimes difficult. They often reveal an underlying pathology, notably infectious, tumoral or hematological. The clinical presentation is usually acute, but progressive forms are possible. The majority of patients are splenectomized.

Materials and Methods: We report a case Spontaneous rupture of the spleen in the department of Emergency visceral surgery.

Results: Our patient was admitted to the emergency room with diffuse abdominal pain of sudden onset with onset of epigastric pain and incoercible vomiting rupture five days before days  the consultation with clinical examination: conscious patient stable on the hemodynamic and respiratory plan The examination noted generalized abdominal defense  the hernial orifices were free, apyrexial, and sensitization of the left hypochondrium. The laboratory investigations was normal. X-ray of the abdomen without preparation (ASP) was without particularities.

The abdominal CT scan showed a medium-sized hemoperitoneum on probable splenic the patient were operated in the emergency room, approached by laparotomy with the exploration we found  a medium-sized hemoperitoneum on probable splenic rupture ,A splenectomy was performed.

Conclusion: Spontaneous rupture of the spleen is a rare entity whose diagnosis is difficult in the absence of a traumatic context. It can be life threatening. Ultrasound and CT scans help to orient the diagnosis.

The overall mortality is about 20% and seems to be mainly related to the delay in diagnosis and/or the severity of the underlying pathology. Infectious etiologies, dominated by Infectious mononucleosis, and hematological etiologies, dominated by hematological malignancies, together account for more than half of the cases.