Life-saving intervention following spontaneous rupture of splenic vein in a young patient: A case report and review of the literature

INTRODUCTION AND IMPORTANCE: The spontaneous rupture of the splenic vein is indeed a rare occurrence, and it carries a high risk of mortality. To date, only a very limited number of documented cases of splenic vein rupture attributed to hepatic cirrhosis have been reported. CASE PRESENTATION: A 17-year-old male patient was urgently referred to our hospital due to sudden severe abdominal pain. Upon admission, the patient displayed critical signs, including abdominal tenderness and shock. Lab results revealed low red blood cell count and elevated creatinine levels. A CT scan uncovered a substantial abdominal fluid accumulation and a ruptured splenic vein alongside a dilated superior mesenteric vein. Emergency exploratory surgery revealed extensive intraperitoneal bleeding due to the splenic vein rupture, leading to a total splenectomy and vein ligation. Surprisingly, histological findings confirmed liver cirrhosis, although the patient had shown no liver-related symptoms prior to surgery. Over six months of careful monitoring, the patient displayed significant improvement in health with no complications or readmissions. CLINICAL DISCUSSION: The rupture of the splenic vein is an uncommon condition that should be taken into consideration when evaluating the potential causes of intra-abdominal hemorrhage, particularly in cirrhotic patients and pregnant women. The appropriate treatment typically involves controlling the hemorrhage and performing the ligation of the splenic vein, often necessitating an urgent splenectomy. CONCLUSION: This case underscores the critical importance of considering uncommon sources of sudden intraperitoneal hemorrhage, such as splenic vein rupture. It also emphasizes the vital role of prompt surgical intervention in such cases.