Spontaneous rupture of the spleen in a child

Abstract

Non traumatic or spontaneous splenic ruptures are rare but potentially fatal. Mortality is mainly due to delayed and therapeutic diagnosis as well as to the risks associated with a predisposed condition and with the severity of underlying pathologies. Splenectomy is necessary in the majority of cases. They can occur either in subject with macroscopically healthy spleen but, for instance, with infectious mononucleosis (IMN) or malaria or in subjects with pathologic spleen due to tumor, for example, but even in patients with some coagulopathies. We here report the case of a 6 year old child followed up for coagulopathy, admitted with diffuse violent abdominal pain, cutaneous-mucous paleness with hemodynamic stability. Laboratory tests showed macrocytic normochromic anemia; the diagnosis of splenic rupture was based on ultrasound and abdominal CT scan. Because the patient was hemodynamically stable, conservative treatment with 2 packed red blood cell transfusions was proposed. Patient’s outcome was favorable.