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February 21, 1977

Spontaneous Rupture of the Spleen in Homozygous Hemoglobin C Disease

JAMA. 1977;237(8):792-793. doi:10.1001/jama.1977.03270350052022

SPONTANEOUS or pathologic rupture of the spleen has been reported in a variety of clinical conditions.1 We report a case of spontaneous splenic rupture in a patient with homozygous hemoglobin C disease.

Report of a Case  A 25-year-old man was hospitalized with an 18-hour history of unremitting abdominal pain located below the umbilicus and associated with two episodes of syncope. There was no history of abdominal trauma, anemia, or jaundice.The patient was well developed and well nourished. Blood pressure was 120/80 mm Hg, without orthostatic change; pulse was 104 beats per minute and the temperature was 37.2 C. Pertinent physical findings included nonicteric sclerae, normal fundi, lungs that were clear to percussion and auscultation, and a hyperdynamic cardiac impulse with a grade 2/6 systolic precordial murmur. There was no hepatosplenomegaly, nor were any masses felt. Voluntary and involuntary muscular guarding with generalized rebound tenderness was present. Bowel sounds