Spontaneous splenic rupture mimicking pneumonia: a case report

A 74-year-old gentleman presented with a history of left-sided pleuritic chest and upper abdominal pain. Examination and chest x-ray findings were suggestive of pneumonia. An abdominal ultrasound was suggestive of spontaneous splenic rupture. An abdominal computed tomography scan showed a splenic laceration and large peri-splenic haematoma. The advice from the on-call surgical team was to treat conservatively but the patient's condition deteriorated suddenly and he died. Spontaneous splenic rupture is uncommon but probably under-diagnosed and should be considered in all patients presenting with non-specific abdominal pain. The optimal management strategy for the older patient with spontaneous ruptured spleen is unknown.