Atraumatic Splenic Rupture After Weight Lifting in a Patient Presenting With Left Shoulder Pain

Abstract

We discuss a 23-year-old active duty male who presented to the emergency department with left shoulder pain after deadlifting heavy weights the day prior. His physical examination revealed a nontender and otherwise unremarkable left shoulder with full range of motion and mild tenderness to palpation in the left upper quadrant of the abdomen. A bedside focused assessment with sonography for trauma (FAST) examination showed free fluid in the abdomen and a computed tomography scan showed a splenic laceration and splenomegaly. He later tested positive for infectious mononucleosis. This is the first case report of atraumatic splenic laceration after heavy weight lifting. This case illustrates the importance of a broad differential and high index of suspicion in the patient with undifferentiated abdominal pain in order to diagnose a potentially fatal disease.

Splenic rupture and subsequent splenectomy in a young healthy victim following Russell's viper bite

“…There are multiple causes for atraumatic or spontaneous splenic rupture such as microbial infection, tumour growth, hyperplasia of splenic cells, physical activities such as weightlifting and rarely, some physiological processes including pregnancy (Halliday et al, 2020;Kaniappan et al, 2018;Lam et al, 2014;Lieberman and Levitt, 1989;Renzulli et al, 2009;Rueda-Esteban et al, 2020). However, the adverse effects of SBE on spleen are rarely encountered.…”

Atraumatic Spleen and Liver Rupture While Weightlifting during Epstein-Barr Virus Convalescence

“…Various noncontact causes of ASR have been reported in the literature including sneezing, coughing, vomiting, muscular exertion, and straining during defecation (23–25). Notably, there has been one previous report of ASR while weightlifting in association with an EBV infection (25). This patient presented similarly to ours with a chief complaint of left shoulder pain following a deadlift maneuver.…”

“…Although less common than traumatic rupture, ASR can occur in patients with infectious mononucleosis (3–7). Various noncontact causes of ASR have been reported in the literature including sneezing, coughing, vomiting, muscular exertion, and straining during defecation (23–25). Notably, there has been one previous report of ASR while weightlifting in association with an EBV infection (25).…”

Unexpected death involving the spleen – an overview

“…16 Other extrinsic sources of increased intraabdominal pressure, such as lifting weights, may also result in splenic rupture. 17…”

“…16 Other extrinsic sources of increased intraabdominal pressure, such as lifting weights, may also result in splenic rupture. 17 Globally, malaria is an important cause of splenomegaly due to Plasmodium protozoa carried by the Anopheles mosquito. 18 Rupture of the spleen is a rare complication of malaria particularly associated with infection by Plasmodium vivax, 19 although it may also occur by other varieties such as Plasmodium knowlesi and Plasmodium falciparum.…”