Journal of Emergencies, Trauma, and Shock🔒 SSL Verified

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"Atraumatic splenic rupture (ASR) is a rare but life-threatening event that usually occurs in diseased spleens and can complicate systemic infections. Among infectious causes, Epstein–Barr virus (EBV) is the most frequently implicated, with rupture recognized as one of the most serious complications of infectious mononucleosis. Although the incidence is estimated at only 0.1%–0.5%, mortality can reach 5%–10% if diagnosis and treatment are delayed. Patients often present with abdominal pain, hypotension, or shock, but symptoms may be subtle and mimic other acute conditions. We report three cases of ASR in older adults. Case 1 involved a 79-year-old man with sudden abdominal pain and hypotension; he deteriorated under conservative management and required emergency splenectomy. EBV serology was positive. Case 2 was a 67-year-old woman admitted with collapse and sepsis-like features; computed tomography (CT) confirmed rupture, and she underwent splenectomy followed by a complicated postoperative course. EBV polymerase chain reaction was positive. Case 3, a 73-year-old woman with recent pneumonia, presented with dizziness and abdominal/back pain; CT confirmed rupture, and she underwent splenectomy. EBV testing was not performed. Histopathology in all three showed capsular rupture with hemorrhage but no lymphoma or malignancy. Each patient received postsplenectomy vaccination and antibiotic prophylaxis. These cases highlight the variable presentation of ASR, including EBV-associated forms, and emphasise the pivotal role of CT in diagnosis and the frequent need for splenectomy in unstable patients. Vigilance, rapid imaging, and adherence to postsplenectomy prophylaxis are critical for improving survival in this uncommon but serious condition."

"A solid pseudopapillary tumor (SPT) of the pancreas is a rare, low-grade epithelial-lined tumor that typically follows a benign course and is potentially curable with surgical excision. We describe a patient presenting to the emergency department with vague abdominal symptoms and moderate tenderness on deep palpation of the right hemiabdomen on exam ination. Computed tomography (CT) imaging showed evidence of an SPT in the tail of the pancreas. An SPT is a rare, low-grade tumor that typically has a benign prognosis and is potentially curable with surgical excision. SPT tumors can be found on CT imaging in the setting of trauma, and it should be in the differential in the setting of vague abdominal symptoms after abdominal trauma. We discuss the presentation, pathophysiology, prognosis, and management of SPTs based on a literature review."

"Superficial thrombophlebitis (STP) is a vascular condition that can mimic deep-vein thrombosis (DVT) and cellulitis, necessitating careful evaluation to guide management. This case report describes the case of a 78-year-old female with a history of recurrent DVT who presented with lower extremity pain and erythema after discontinuing anticoagulation. Point-of-care ultrasound revealed a superficial venous thrombus with noncompressibility, confirming STP, while additional imaging identified chronic thrombi in the deep venous system."

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