Atraumatic Splenic Rupture after Myocardial Infarction

Abstract

Atraumatic splenic rupture is a rare but potentially life-threatening event. It mostly happens when the spleen is already diseased; however, sometimes it can be drug induced in a previously normal spleen. Although anticoagulation has been attributed to spontaneous splenic rupture quite frequently, the role of dual antiplatelet therapy is underestimated. We report a case of an 80-year-old woman who developed spontaneous splenic rupture 4 weeks after starting dual antiplatelet therapy. LEARNING POINTS• Atraumatic or spontaneous splenic rupture can be life threatening.• Various drugs, including granulocyte colony-stimulating factors (GCSF) and anticoagulants, can result in atraumatic splenic rupture in a previously normal spleen.• Dual antiplatelet therapy can also cause splenic rupture in a previously normal spleen. It can occur as early as a few weeks after initiation of treatment.

Atraumatic Splenic Rupture in Legionella pneumophila Pneumonia

“…Potentially, the same holds true for the immunologic insult leading to ASR. ASR has been described in multiple settings in which malignancy, viral infection, inflammatory and iatrogenic causes (e.g., antiplatelets and anticoagulants) predominate [ 11 , 35 ]. Other at risk groups include women during late pregnancy (3 rd trimester) or those with ectopic pregnancies in whom this differential should be considered given the raised intra-abdominal pressure from the gravid uterus [ 36 ].…”

A case report of atraumatic splenic rupture after coronary stenting and dual antiplatelet therapy: Causality or relationship?

“…Despite of anticoagulant and anti-aggregating drug-related ASR has already been described in literature as a dangerous complication with an high mortality rate, due to the rarity of the disease, anticoagulant and anti-aggregating drug-related ASR are usually collected together although different indications, pharmacology, and side effects [10] . In fact, regarding anti-aggregating therapy drug-related ASR, only four cases of splenic rupture on Ticlopidine [5] and three during DAPT were reported as chronic complication, respectively after 14 days, 4 weeks, and 7 months [2] , [9] , [11] .…”

“…Splenic rupture (SR) is the most common trauma related injuries [1] . Conversely, atraumatic splenic rupture (ASR) is a rare event and represents an even more challenging management, due to the absence of clinical history of trauma and delayed diagnosis [2] .…”

A Spleen Complication After an Acute Myocardial Infarction

“…It is a serious condition and can be life-threatening. Both anticoagulants ( 1 ) and antiplatelets ( 2 ) have been associated with atraumatic splenic rupture. There are no guidelines on its management, but it is recommended that young and stable patients be treated conservatively.…”