title: Spontaneous splenic rupture following the administration of intravenous heparin: case report and retrospective case review.
abstract: We report the case of a 40-year-old African-American female who presented to the Emergency Department with unstable angina. The patient, who had multiple risk factors for coronary artery disease, was admitted to the coronary care unit for cardiac work-up and management. Shortly after the intravenous administration of unfractionated heparin, she suffered the acute onset of upper abdominal pain and shock. A CT scan of the abdomen revealed splenic rupture with hemoperitoneum. The patient, who was managed surgically, had complete recovery before discharge. A review of systems and medical records revealed no obvious risk factors or other potential etiology for this rupture. We herein provide the characteristics of this rarely documented causal relationship between heparin and spontaneous splenic rupture and retrospectively review similar cases in the literature.
authors.affiliation: Mercy Catholic Medical Center, Department of Medicine, Mercy Fitzgerald Hospital/Mercy Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. ghobrial@hotmail.com
authors.forename: Michel W
authors.initials: MW
authors.lastname: Ghobrial
authors.forename: Mohammad
authors.initials: M
authors.lastname: Karim
authors.forename: Sunitha
authors.initials: S
authors.lastname: Mannam
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D044383:Black People; D003327:Coronary Disease / Q000188:drug therapy*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D015143:Philadelphia; D012422:Rupture, Spontaneous / Q000209:etiology; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D001741:Black or African American
chemical_list: D000925:Anticoagulants; D006493:Heparin