Delayed splenic rupture presenting as atypical chest pain and right bundle branch block

Abstract

Introduction: Although splenic injury is the most frequent abdominal injury resulting from blunt trauma, delayed splenic rupture is a rare event. Traumatic rupture of the spleen has been well described in medical literature and is found in approximately 30% of patients undergoing surgery for blunt abdominal injury. Computed tomography negative delayed rupture of the spleen is a very rare clinical entity. This is in spite of computed tomography having a sensitivity and specificity for detection of splenic injuries as high as 96% and 100%, respectively. When a patient presents after blunt abdominal trauma, awareness of the problem of delayed splenic rupture, a high index of clinical suspicion and rapid diagnostic approach may help reducing the morbidity and mortality associated with unrecognized splenic injury and/or hemorrhage. Case Report: We present a case report of a 61­year­old male restrained driver, involved in a motor vehicle crash, who presented with a normal spleen on initial computed tomography scan. Conclusion: Computed tomography ­ negative delayed rupture of the spleen is a very rare clinical entity.