SPECIAL ARTICLE   

Minerva Surgery 2023 February;78(1):86-91

DOI: 10.23736/S2724-5691.22.09718-0

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Atraumatic splenic rupture in COVID-19 era: case report and systematic literature review

Francesco S. LUCIDO ¹, Giusiana NESTA ¹ ✉, Claudio GAMBARDELLA ¹, Giuseppe SCOGNAMIGLIO ², Francesco PIZZA ³, Luigi BRUSCIANO ¹, Salvatore TOLONE ¹, Simona PARISI ¹, Alfredo ALLARIA ¹, Ludovico DOCIMO ¹

¹ Division of General, Mini-invasive, Oncological and Bariatric Surgery, Luigi Vanvitelli University of Campania, Naples, Italy; ² Unit of General and Bariatric Surgery, Camilliani Hospital, Casoria, Naples, Italy; ³ Department of Surgery, A. Rizzoli Hospital, Lacco Ameno, Naples, Italy

Atraumatic splenic rupture is a rare but life-threatening condition. The Coronavirus disease 2019 (COVID-19) is still a mysterious infection, often associated with spontaneous bleeding and coagulation disorders. Among them, a rare presentation is the atraumatic splenic rupture during SARS-CoV-2 infection. We reported the case of a COVID-19 patient that underwent splenectomy for a spontaneous splenic rupture without splenomegaly or any hematological disorders. Moreover, we reviewed the literature about this matter focusing on the hypothetical etiopathogenesis of this condition in COVID-19 patients. Twelve cases of atraumatic splenic rupture without splenomegaly were reported in ten papers. Coughing, respiratory tract infections and anticoagulant treatment were postulated as the main risk factors for the spontaneous splenic rupture. COVID-19 is still a not well-known disease with multiple clinical presentations. The spontaneous splenic rupture is uncommon in general population but this event should not be neglected in this particular subset of patients.

KEY WORDS: Hemorrhage; Splenic rupture; COVID-19