Spontaneous Rupture of the Spleen in Acute Myeloid Leukaemia

Spontaneous rupture of the spleen in acute leukæmia is of extreme rarity. A case is reported of a patient with untreated acute myelomonocytic leukæmia without obvious splenic enlargement, who while under close observation in hospital was awakened from sleep by severe epigastric pain. After considerable diagnostic difficulties, laparotomy was performed, and a grossly disrupted and fragmented spleen weighing 240 gm was successfully removed. The patient died four days later from an unexpected cardiac arrest. The literature and mechanisms of spontaneous splenic rupture in acute leukæmia are briefly reviewed.