[Nonoperative management of spontaneous splenic rupture in infectious mononucleosis]

Andrzej B Szczepanik, Sławomir Gajda, Anna M Szczepanik, Andrzej Misiak
Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego 2011, 30 (178): 265-7

UNLABELLED: Spontaneous splenic rupture is a rare complication of infectious mononucleosis observed in 0.1-0.5% of patients with this condition. Mandatory mode of management in hemodynamically stable patients is nonoperative treatment. We report the case of a 19-year old man with splenic rupture, during the course of serological and hematological confirmed infectious mononucleosis, with no history of trauma. Parenchymal and subcapsular splenic hematomas and presence of blood in vesico-rectal recess was demonstrated. Circulatory and respiratory findings and blood cell count were stable. Nonoperative management was instituted which comprised monitoring of valid vital signs, serial USG and tomography scans and vital activity limitation. Imaging radiological investigations demonstrated disappearance of observed abnormalities on post admission day 20. The patient was discharged from the hospital in good general condition.

CONCLUSION: Nonoperative management can be a safe alternative to splenectomy in hemodynamically stable patient with spontaneous rupture of the spleen.

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