title: Pathological splenic rupture: a rare complication of chronic myelomonocytic leukemia.
abstract: Chronic myelomonocytic leukemia (CMML) is an uncommon disorder characterized by monocytosis of the peripheral blood, absence of the Philadelphia chromosome, fewer than 20% blasts, and one or more lineages showing dysplastic features. Splenomegaly is frequently seen and may be massive. A 56-year-old man with stable CMML and moderate splenomegaly presented to the emergency department with generalized abdominal pain and abrupt drop in hemoglobin. Abdominal imaging revealed splenic rupture and emergency splenectomy was undertaken, with complete recovery. Atraumatic rupture of the spleen has rarely been reported as a complication of CMML or other myelodysplastic disorders. This report should alert physicians to consider this diagnosis in patients with CMML and acute abdominal pain.
authors.affiliation: Myelodysplastic Syndrome Research Program, Department of Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Shannon Lynn
authors.initials: SL
authors.lastname: Goddard
authors.forename: Alden E
authors.initials: AE
authors.lastname: Chesney
authors.forename: Marciano D
authors.initials: MD
authors.lastname: Reis
authors.forename: Zeina
authors.initials: Z
authors.lastname: Ghorab
authors.forename: Mike
authors.initials: M
authors.lastname: Brzozowski
authors.forename: Frances C
authors.initials: FC
authors.lastname: Wright
authors.forename: Richard A
authors.initials: RA
authors.lastname: Wells
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology*; D004630:Emergencies; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D015477:Leukemia, Myelomonocytic, Chronic / Q000150:complications*; D017254:Leukemic Infiltration; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D013154:Spleen / Q000473:pathology; D013156:Splenectomy; D013161:Splenic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013163:Splenomegaly / Q000209:etiology