J Acute Care Surg.  2019 Oct;9(2):69-71. 10.17479/jacs.2019.9.2.69.

Nontraumatic Splenic Rupture due to Infectious Mononucleosis

Affiliations
  • 1Lincoln Family Medicine Residency Program, Lincoln Medical Education Partnership, Lincoln, NE, USA. elliotfrankmd@gmail.com
  • 2Idaho State University, Department of Physician Assistant Studies, Idaho State University, Idaho, ID, USA.
  • 3The College of Idaho, Department of Physician Assistant Studies, Idaho, ID, USA.
  • 4Bryan Trauma/Acute Care surgery, Lincoln, Nebraska, NE, USA.

Abstract

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.

Keyword

Epstein-Barr virus; infectious mononucleosis; splenectomy; splenic rupture

MeSH Terms

Abdomen
Abdominal Pain
Cough
Dizziness
Emergency Service, Hospital
Estrogens, Conjugated (USP)
Follow-Up Studies
Herpesvirus 4, Human
Humans
Infectious Mononucleosis*
Laparotomy
Male
Nausea
Pharyngitis
Spleen
Splenectomy
Splenic Rupture*
Young Adult
Estrogens, Conjugated (USP)
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