Splenic rupture in infectious mononucleosis: A systematic review of published case reports

Bartlett, A.; Williams, Ruth; Hilton, Malcolm P

doi:10.1016/j.injury.2015.10.071

Cited by 74 publications

(117 citation statements)

References 45 publications

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“…Vomiting following splenic rupture is rare but may occur following pressure on the stomach from a haematoma 12. Occasionally, patients have presented with chest pain, or even in full cardiorespiratory arrest, with a preceding history of worsening abdominal pain 8. Rarely, patients have been seen to complain of a headache after splenic injury 13…”

Section: Discussionmentioning

confidence: 99%

“…IM is associated with some degree of splenomegaly in the majority of cases,9 and consequently an increased risk of splenic rupture, both spontaneous and traumatic 8. Such incidents are rare, occurring in 0.5%–1% of patients with IM,7 10 but are associated with severe risks, including death from haemorrhage, and lifelong susceptibility to bacterial and protozoal infections after splenectomy 11…”

Section: Introductionmentioning

confidence: 99%

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Confusion and abdominal symptoms following a rugby tackle

Ioannides

Davies

Kluzek³

2017

BMJ Case Reports

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A 19-year-old man was sent to the emergency department following a pitch-side assessment for suspected concussion, unexplained upper abdominal tenderness and vomiting, following a high-impact tackle during a rugby match. A Focussed Assessment with Sonography for Trauma (FAST) scan performed in the emergency department suggested intra-abdominal free fluid, and subsequent head and abdominal CT imaging showed no intracranial lesion but confirmed a significant haemoperitoneum due to large splenic tear and bleeding. An emergency splenectomy was performed, which confirmed the rupture of an enlarged spleen with blood loss of almost 2 L into the peritoneal cavity. The patient made a full recovery following surgery. A subsequent histological examination revealed granulomatous inflammation characteristic of infectious mononucleosis. This unique case illustrates that physically fit patients with early hypovolaemic shock can present with symptoms mimicking concussion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Confusion and abdominal symptoms following a rugby tackle

Ioannides

Davies

Kluzek³

2017

BMJ Case Reports

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“…This calls into question the reliability of such examination, especially when the risk of splenic rupture, albeit rare, is on the table (31)(32)(33)(34). Because of this the benefits of imaging, such as ultrasound (US) or computed tomography (CT) are seen and allow for the best counseling of your young athlete.…”

Section: Examinationmentioning

confidence: 99%

“…Splenic rupture is exceedingly rare, occurring between 0.1% and 0.2% of cases accounting for both traumatic and nontraumatic mechanisms (32). When it does occur, splenic rupture typically does so in the first 4 weeks of illness (33,34). With this it is generally deemed safe to return to light activity 3 weeks after the onset of illness which has caused or is known to cause splenomegaly.…”

Section: Returning To Play and The Potential Consequences Of Splenomementioning

confidence: 99%

Gastrointestinal considerations related to youth sports and the young athlete

Koon¹,

Atay²,

Lapsia³

2017

Transl. Pediatr.

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Young athletes, though often healthy, can carry a variety of symptoms that may impede their participation in sports or other activities. Typically we might think of musculoskeletal and respiratory problems primarily, however disorders of the gastrointestinal (GI) tract must also be considered. In some instances musculoskeletal complaints may bring to light activity of an underlying GI condition as is the case with inflammatory bowel disease. Gastrointestinal symptoms in the young athlete can be quite significant and a nuisance for participation. We aim to describe and discuss treatment options of a few conditions targeted specifically for your young athlete both that arise specifically from athletic participation and those GI disorders that are chronic in nature whose presence must not be neglected in the athlete.

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“…It is associated with splenomegaly in about 15–65% of cases which is commonly seen as an increased risk for traumatic rupture 10 11. Therefore recommendations are usually made to avoid contact sport for the duration of 8 weeks 11…”

Section: Introductionmentioning

confidence: 99%