Spontaneous splenic rupture (SSR) is a relatively rare but potentially lethal complication of infectious mononucleosis (IM). While SSR is extremely rare in patients with proven IM, it is the most lethal complication of the infection (9% mortality rate) and can present completely asymptomatically or with abdominal pain and hemodynamic instability. As adolescents and young adults are the most affected population group, with this case report, we intend to raise the vigilance of any doctor treating those patients in the emergency department. We present the case of a 16-year-old patient with an atraumatic splenic rupture and hemoperitoneum secondary to an Epstein–Barr virus (EBV) infection. The patient underwent an exploratory laparotomy, and a splenectomy was performed. This case demonstrates that, even if SSR in patients with IM is extremely rare, it should always be considered in a patient with a relevant clinical presentation.
Spontaneous splenic rupture (SSR) is a relatively rare, but potentially lethal complication of infectious mononucleosis (IM). While SSR is extremely rare in patients with proven IM, it is the most lethal complication of the infection (9% mortality rate) and can present completely asymptomatically or with abdominal pain and hemodynamic instability. As adolescents and young adults are the most affected population group, with this case report we intend to raise the vigilance of any doctor treating those patients in the emergency department. We present the case of a 16-year-old patient with an atraumatic splenic rupture and hemoperitoneum secondary to an Epstein-Barr virus (EBV) infection. The patient underwent an exploratory laparotomy, and a splenectomy was performed. This case demonstrates that even if the SSR in patients with IM is extremely rare, it should be always considered in a patient with relevant clinical presentation.
In this 10-year retrospective study we used the data from patients who were operated upon due to acute bowel obstruction, at the Surgical Department of General Hospital of Katerini in Greece, from 2012 to 2022. Patients were classified based on the date of operation, their sex, their age group (ranging from 26 to 92 years) and the etiology of the bowel obstruction. A sample of 197 patients was studied. Out of these, it was found that in 73 (37%) the cause of the obstruction was colorectal cancer. In 46 of those patients (63%) the tumor was resected, while in the remaining 27 (37%), some kind of diverting stoma was installed. In 17(43,5%) of the 39 total patients, who suffered from some kind of rectosigmoid cancer, Hartmann's operation was chosen. Our results showcase that, at district hospitals, the surgeon is sometimes obligated to a damage control approach regarding obstructive colon cancer and thus the majority of the patients will eventually end up with a stoma.