Abstract:
Spontaneous rupture of the spleen is a rare, but serious complication of infectious mononucleosis with no clear consensus
on appropriate management. Although management of traumatic splenic rupture has largely moved to non-operative treatment,
splenectomy is still frequently used in dealing with rupture of the diseased spleen. Here we report the case of a 27-year-old boy
with splenic rupture secondary to laboratory-confirmed infectious mononucleosis in the absence of trauma. Our management
included an endovascular treatment (embolization of the splenic artery), serial ultrasound scans, activity limitation, and a computed
tomography low-dose scan before discharge. Our experience, along with a review of the literature, has led us to conclude
that splenic preservation can be a safe alternative to splenectomy in hemodynamically stable patients with spontaneous splenic
rupture. This is of particular importance in the young population, which is at higher risk for postsplenectomy sepsis.
