{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T22:55:34Z","timestamp":1784588134215,"version":"3.55.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Spontaneous splenic rupture (SSR) is a rare but potentially fatal condition. It is commonly linked to underlying conditions such as infections, neoplasms, or hematologic diseases. SSR can also occur in a healthy spleen without any associated pathology, termed idiopathic splenic rupture. Symptoms range from non-specific abdominal pain to hemodynamic instability, often requiring emergency splenectomy. Early recognition using CT is crucial for improving outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 32-year-old male presented with severe abdominal pain for 24 h. Examination showed stable hemodynamics but tenderness in the left upper quadrant. CT revealed a subcapsular hematoma and moderate hemoperitoneum, leading to a diagnosis of SSR. Initially managed conservatively, the patient developed hemorrhagic shock 24 h later, with hemoglobin decreasing to 6.2 g\/dL. An exploratory laparotomy confirmed a superior pole splenic fracture with significant hemoperitoneum, necessitating a total splenectomy. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 6 with prophylactic vaccinations and lifelong penicillin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>SSR in a normal spleen is extremely rare and poses significant diagnostic and therapeutic challenges. The exact mechanisms are unclear, with theories including vascular anomalies, microtrauma, increased splenic pressure, and idiopathic factors. SSR symptoms are often non-specific, leading to misdiagnosis. Timely diagnosis using imaging, particularly contrast-enhanced CT, is essential. Management varies from conservative approaches to splenectomy, based on hemodynamic stability and splenic damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Spontaneous rupture of a normal spleen is a critical condition requiring high clinical suspicion for timely diagnosis and management. Further research is needed to understand its pathophysiology and risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2024.110179","type":"journal-article","created":{"date-parts":[[2024,8,15]],"date-time":"2024-08-15T02:32:09Z","timestamp":1723689129000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Spontaneous rupture of a normal spleen: A case report and a review of the literature emphasizing diagnostic and surgical challenges"],"prefix":"10.1097","volume":"123","author":[{"given":"Imen","family":"Ben Ismail","sequence":"first","affiliation":[{"name":"University of Tunis El Manar, Department of General Surgery, Trauma Center Ben Arous, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwen","family":"Sghaier","sequence":"additional","affiliation":[{"name":"University of Tunis El Manar, Department of General Surgery, Trauma Center Ben Arous, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmontassar Belleh","family":"Zaafouri","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saber","family":"Rebii","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Trauma and Burns Center, Ben Arous, University of Tunis El Manar, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Helal","sequence":"additional","affiliation":[{"name":"University of Tunis El Manar, Department of Pathology, Habib Thameur Hospital, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja","family":"Jouini","sequence":"additional","affiliation":[{"name":"University of Tunis El Manar, Department of Pathology, Habib Thameur Hospital, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayoub","family":"Zoghlami","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Trauma and Burns Center, Ben Arous, University of Tunis El Manar, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"36","key":"R1-18-20260507","article-title":"Spontaneous splenic rupture: case report and review of literature","volume":"37","author":"Ahbala,","year":"2020","journal-title":"Pan Afr. 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