Atraumatic splenic rupture

Discussion:

This patient had been treated with peritoneal dialysis for a number of years. There was no history of recent or remote trauma, and the patient was essentially asymptomatic aside from bloody peritoneal dialysate and mild abdominal pain. 

Atraumatic splenic rupture has been reported as a rare occurrence in both haemodialysis and peritoneal dialysis patients. In a series of 22 dialysis patients who had splenectomy for atraumatic rupture 1, amyloidosis was the most common underlying pathology (~30%), with other underlying pathology including splenomegaly, hemosiderosis, splenic infarcts, and tuberculous granulomas. 

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