{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:39:37Z","timestamp":1787938777171,"version":"build-2784847793"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Spontaneous splenic rupture (SSR) is an uncommon and potentially life-threatening cause of acute abdominal pain, often linked to underlying pathology. Because its presentation can mimic more common conditions, diagnosis is frequently delayed. We report a case from a resource-limited setting where SSR initially mimicked peptic ulcer disease, underscoring diagnostic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation:<\/jats:title>\n                    <jats:p>A 57-year-old Ethiopian woman with chronic reflux presented after 5\u2009days of severe epigastric pain radiating to the left shoulder, with nausea and vomiting but no trauma or fever. Initial labs showed mild anemia. Abdominal examination revealed localized epigastric tenderness without peritonism. The initial working diagnosis was peptic ulcer disease; proton pump inhibitors were started, and endoscopy was unavailable. After 2\u2009days, she developed hypotension and left upper quadrant pain. Bedside ultrasound (FAST) showed free intraperitoneal fluid, and contrast CT confirmed a ruptured spleen with hemoperitoneum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management and Outcome:<\/jats:title>\n                    <jats:p>The patient underwent emergency laparotomy, which found a shattered spleen and ~3.5\u2009L of intra-abdominal blood; a splenectomy was performed. She required an intraoperative transfusion and was stabilized. Histopathology confirmed a normal spleen with preserved architecture, supporting a diagnosis of idiopathic rupture possibly related to transient microvascular congestion. Postoperatively, she recovered uneventfully and was discharged on postoperative day 5. She received the vaccinations needed and was counseled about infection risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case illustrates that true spontaneous rupture can occur in a histologically normal spleen and may mimic peptic ulcer disease in presentation. Recognizing atypical features and ensuring timely imaging are crucial, especially in resource-limited settings where delayed diagnosis increases mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795476251401285","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T15:53:08Z","timestamp":1764863588000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["True Spontaneous Splenic Rupture Mimicking Peptic Ulcer Disease: A Case Report"],"prefix":"10.1177","volume":"18","author":[{"given":"Dereje G.","family":"Andargie","sequence":"first","affiliation":[{"name":"Department of Surgery, College of Medicine and Health Science, University of Rwanda, Kigali, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4647-111X","authenticated-orcid":false,"given":"Biruk T.","family":"Mengistie","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0061-6458","authenticated-orcid":false,"given":"Chernet T.","family":"Mengistie","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelalem L.","family":"Adigeh","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine and Health Sciences, Bahir Dar University, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel","family":"Ami","sequence":"additional","affiliation":[{"name":"Kirehe District Hospital, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2024.110179"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/5827694","article-title":"Diagnosis and treatment of atraumatic splenic rupture: experience of 8 cases","volume":"2019","author":"Liu J","year":"2019","unstructured":"Liu J, Feng Y, Li A, Liu C, Li F. Diagnosis and treatment of atraumatic splenic rupture: experience of 8 cases. Gastroenterol Res Pract. 2019;2019:1-5.","journal-title":"Gastroenterol Res Pract"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6737"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-14-00143.1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4702-1"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0b013e32833ddeb5"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2024.110783"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2014-204891"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2024.02.016"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-5-444"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.54536\/ajmsi.v2i2.2122"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.21037\/cco-24-122"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-3071"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S179902"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268816002405"},{"key":"e_1_3_3_17_2","first-page":"36","article-title":"Spontaneous splenic rupture: case report and review of literature","volume":"37","author":"Ahbala T","year":"2020","unstructured":"Ahbala T, Rabbani K, Louzi A, Finech B. Spontaneous splenic rupture: case report and review of literature. Pan Afr Med J. 2020;37:36.","journal-title":"Pan Afr Med J"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.4236\/ss.2025.161005"},{"issue":"4","key":"e_1_3_3_19_2","first-page":"523","article-title":"Ruptura espl\u00e9nica espont\u00e1nea. Reporte de caso y revisi\u00f3n de la literatura","volume":"61","author":"Reyes-Jaimes L","year":"2023","unstructured":"Reyes-Jaimes L, Camacho-Aguilera JF. Ruptura espl\u00e9nica espont\u00e1nea. Reporte de caso y revisi\u00f3n de la literatura [Spontaneous splenic rupture. Case report and literature review]. 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