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BMJ Case Rep. 2013 Apr 23;2013. pii: bcr2013008851. doi: 10.1136/bcr-2013-008851.

Spontaneous splenic rupture presenting as haemoperitoneum: coinfection of Plasmodium vivax and Plasmodium falciparum.

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Department of Surgery, King George Medical University, Lucknow, Uttar Pradesh, India.


Non-traumatic splenic rupture has been described in the medical literature as a clinical entity with grave consequences, if diagnosis and subsequent treatment are delayed. Various pathological reasons implicated in non-traumatic spontaneous splenic rupture have been described in literature ranging from infection, malignancy, metabolic disorders as well as haematological malignancies. This case reports a 30-year-old man who presented in the emergency department with complaints of fever and a sudden-onset abdominal pain with no history of trauma. At hospital admission, abdominal tenderness with splenomegaly was present with free fluid in abdomen. Haematological investigations established the coinfection of Plasmodium falciparum and Plasmodium vivax. Radiological investigations revealed splenic laceration with moderate haemoperitoneum. The patient was managed conservatively with strict vital monitoring. Later on, elective splenectomy was performed. The authors report only the second case in literature with coinfection of plasmodium species presenting with haemoperitoneum.

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