Failure of conservative management of splenic rupture in a patient with mononucleosis

Acute Cytomegalovirus Infection Associated With Splenic Infarction: A Case Report and Review of the Literature

“…More commonly, splenic rupture has been reported in infectious mononucleosis (IM), though many of the early studies did not differentiate between EBV and CMV, both of which are known to cause IM [ 16 ]. Although a rare event, fatalities have occurred with acute splenic haemorrhage the most common cause of death in IM [ 17 ]. The risk of death from splenic rupture specifically associated with CMV is unknown, but a systematic review by Bartlett et al of 85 cases of splenic rupture with IM reported a 9% mortality [ 18 ].…”

Splenectomy in severe haemophilia

“…The management of rupture of the pathological spleen is less clear 49−56 . Recent papers have suggested that carefully selected patients with pathologically abnormal spleens can be managed conservatively 57 .…”

Unusual case of acute onset abdominal pain: uses and limitations of medical imaging

“…Conservative (non-operative) therapy is widely accepted for patients with traumatic splenic rupture who are stable, but the literature is less clear in cases of spontaneous rupture, where most surgeons still advocate splenectomy. Reports of conservative therapy are becoming more common; [19][20][21] therefore, a trial of conservative management was attempted in our patient. Again, it should be emphasized that in an unstable patient, the decision to proceed to the operating room should be based on clinical suspicion of active hemorrhage and, if available and appropriate, demonstration of free fluid on ultrasound.…”