Splenic rupture in infectious mononucleosis

Q; 21 years old male is brought from a football game due to severe left abdominal pain. Patient was recently diagnosed with infectious mononucleosis. Workup showed a ruptured spleen. After the diagnosis of infectious mononucleosis, how long does the risk of splenic rupture persist?

Answer: About eight weeks

Splenomegaly after infectious mononucleosis carries a relatively increased risk of splenic rupture. This risk may persist for up to eight weeks after the onset of symptoms. The first three weeks carry the highest risk.

Ultrasound can be performed, though not required to document the resolution of splenomegaly.

#GI

#surgical-critical-care

References:

1. Ali J. Spontaneous rupture of the spleen in patients with infectious mononucleosis. Can J Surg 1993; 36:49.

2. Bartlett A, Williams R, Hilton M. Splenic rupture in infectious mononucleosis: A systematic review of published case reports. Injury 2016; 47:531.