A 19-year-old otherwise healthy male presented to the Emergency Department with left upper quadrant abdominal pain having felt a “pop” in his abdomen which was followed by nausea and lightheadedness. There was no evidence of trauma but 3 weeks earlier he began with symptoms of a sore throat and nasal congestion without cough. On subsequent investigation, given the patient’s acute abdominal pain, abnormal vitals and a non-diagnostic computed tomography scan, an emergent exploratory laparotomy was performed. There was 600 mL of blood evacuated from the abdomen. A 643-gram inflamed and ruptured spleen was identified and removed, and follow-up lab work was positive for heterophile antibody. This report describes spontaneous splenic rupture caused by infectious mononucleosis and compares characteristics of traumatic versus non-traumatic cases.

Citations

• Splenic rupture or infarction associated with Epstein-Barr virus infectious mononucleosis: a systematic literature review
  Johannes M. A. Toti, Beatrice Gatti, Isabella Hunjan, Lisa Kottanattu, Pietro B. Faré, Samuele Renzi, Mario G. Bianchetti, Gregorio P. Milani, Sebastiano A. G. Lava, Pietro Camozzi
  Swiss Medical Weekly.2023; 153(5): 40081.     CrossRef
• Esplenectomía laparoscópica mano asistida en ruptura esplénica atraumática secundaria a mononucleosis: reporte de un caso
  Lucía Sagüi-De la Fuente, Ana Fernanda Álvarez-Barragán, Guadalupe Javier Palacios-Saucedo, José Javier García-Salas, Guillermo Daniel Almaraz-Celis
  Revista Mexicana de Cirugía Endoscópica.2021; 22(2): 89.     CrossRef