Management of Splenectomy in Haemophilia: Case of Spontaneous Rupture of Spleen Due to Glandular Fever in a Haemophiliac

Spontaneous Rupture of the Spleen in Infectious Mononucleosis Presenting in the Casualty Department

“…The rate in the twenty-one cases described by Smith (1956) was just over 33%. The impression gained from recent cases is that the mortality rate is improving.…”

“…Writers stress the need to avoid splenic palpation in patients suspected of suffering from infectious mononucleosis for fear of injuring the spleen. Smith (1956) believed that an initial bleed may occur into the sub-capsular layer. This would be followed by further sub-capsular bleeds finally ending with a massive intra-peritoneal haemorrhage.…”

“…However, the picture can be complicated by conditions which need specific treatment such as thrombocytopenia (Wetherill and Oldfield 1963) and haemophilia (Smith 1965).…”

“…Over recent years the condition has been documented more frequently; I have found references to fourteen cases in the last three years and presumably many more cases have not been documented. The most recent reports in the English Journals are by Freeman (1962), Wetherill and Oldfield (1963), and Smith (1965).…”

Blunt abdominal trauma with delayed rupture of splenic haematoma in a haemophiliac patient

“…In addition to trauma, disorders such as infectious mononucleosis and chronic malaria may predispose to spontaneous splenic rupture with life‐threatening intra‐abdominal bleeding [1]. There are only a few case reports of splenic rupture in patients with inherited bleeding disorders [1–17]. We report a case of post‐traumatic splenic haematoma in a haemophilia A patient whereby after initial conservative management with factor VIII (FVIII) replacement therapy for 1 month, delayed rupture of the haematoma occurred.…”