EGS P35 Spontaneous rupture of the spleen: Is it caused by COVID?

Abstract

Abstract Background Spontaneous rupture of spleen (SSR) is rare but known entity in patients with underlying pathology of spleen1. However, there are reports of spontaneous splenic rupture in patients with no known underlying pathology2. With the onset of COVID pandemic, rising incidence of various disease conditions were linked to either COVID infection or vaccine. Similarly, we are presenting three cases of spontaneous splenic rupture managed by our team in last one year which could be attributed to COVID infection or vaccine. Methods The data of all the patients admitted in an urban tertiary Upper GI Unit with spontaneous splenic rupture in last one year was collected prospectively from online data storage software called Flex Prod. The data was extracted from this software and analysed retrospectively maintaining patient confidentiality throughout the process. Results Three patients of spontaneous splenic rupture received treatment post COVID in this trust. 2 out of 3 patients had COVID infection in the past and all three had received vaccine. Two patients presented to A&E with hypotension and tachycardia, were appropriately resuscitated, and then underwent successful angio-embolization. Both were monitored in the critical care in the periprocedural period and subsequently transferred to the ward. Third patient presented to A/E with upper abdominal pain and tachycardia, CT scan showed high grade rupture of spleen with low haemoglobin. Hence, angioembolization was carried out, patient recovered well postoperatively and was discharged. Conclusions Spontaneous rupture of spleen is rare but potentially life-threatening condition more common in patients with underlying spleen pathology3. The etiology of SSR is uncertain, however, recent case reports of patients with COVID presenting with spontaneous splenic rupture4 has led to increased interest in COVID as a cause of SSR in the post COVID era.