Acute Abdomen Due to Spontaneous Splenic Rupture in an Adult Polycystic Kidney Disease Patient: A Case Report

Abstract

Adult polycystic kidney disease (APKD) is a hereditary disorder characterized by renal and extrarenal manifestations. While renal complications are well recognized, spontaneous splenic rupture in APKD is exceptionally rare, with the available literature largely limited to isolated case reports; however, atraumatic splenic rupture overall has been estimated to account for only 0.1–0.5% of splenic ruptures and carries a reported mortality rate of ~12.2%, largely due to delayed diagnosis and uncontrolled intraperitoneal hemorrhage. We report the case of a 68‐year‐old male with APKD who presented with severe left upper quadrant (LUQ) abdominal pain, fever, and jaundice. Initial evaluation demonstrated splenomegaly with splenic lacerations, as well as a distal common bile duct (CBD) stone causing obstructive jaundice. Despite antibiotic therapy, the patient developed persistent fever and an acute drop in hemoglobin, raising concern for ongoing intra‐abdominal hemorrhage. Endoscopic retrograde cholangiopancreatography (ERCP) was performed for CBD stone extraction and biliary stent placement. Due to continued bleeding, splenic artery embolization (SAE) was subsequently performed, achieving hemostasis while preserving splenic function. This case highlights the importance of maintaining clinical vigilance for rare but potentially fatal extrarenal complications in patients with APKD. In patients with this condition who present with abdominal pain, fever, jaundice, or unexplained anemia, splenic pathology should be considered in the differential diagnosis. Early diagnosis and timely multidisciplinary intervention, including endoscopic and interventional radiology techniques, can be life‐saving and may avoid the need for splenectomy.

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BibTeX RIS

BibTeX

@article{ahmed2026acute,
  title = {{Acute Abdomen Due to Spontaneous Splenic Rupture in an Adult Polycystic Kidney Disease Patient: A Case Report}},
  author = {Suhaila Ahamed Ahmed and Maryam Khan and Fathima Shabrina Rizni and Labib Sallam Darwish Al Ozaibi and Rafay Gul},
  journal = {Case Reports in Surgery},
  year = {2026},
  month = nov,
  doi = {10.1155/cris/9328289},
  url = {https://doi.org/10.1155/cris/9328289},
  note = {CC BY 4.0},
}

RIS

TY  - JOUR
TI  - Acute Abdomen Due to Spontaneous Splenic Rupture in an Adult Polycystic Kidney Disease Patient: A Case Report
AU  - Suhaila Ahamed Ahmed
AU  - Maryam Khan
AU  - Fathima Shabrina Rizni
AU  - Labib Sallam Darwish Al Ozaibi
AU  - Rafay Gul
PY  - 2026
DA  - 2026/11/09
JO  - Case Reports in Surgery
DO  - 10.1155/cris/9328289
UR  - https://doi.org/10.1155/cris/9328289
AB  - Adult polycystic kidney disease (APKD) is a hereditary disorder characterized by renal and extrarenal manifestations. While renal complications are well recognized, spontaneous splenic rupture in APKD is exceptionally rare, with the available literature largely limited to isolated case reports; however, atraumatic splenic rupture overall has been estimated to account for only 0.1–0.5% of splenic ruptures and carries a reported mortality rate of ~12.2%, largely due to delayed diagnosis and uncontrolled intraperitoneal hemorrhage. We report the case of a 68‐year‐old male with APKD who presented with severe left upper quadrant (LUQ) abdominal pain, fever, and jaundice. Initial evaluation demonstrated splenomegaly with splenic lacerations, as well as a distal common bile duct (CBD) stone causing obstructive jaundice. Despite antibiotic therapy, the patient developed persistent fever and an acute drop in hemoglobin, raising concern for ongoing intra‐abdominal hemorrhage. Endoscopic retrograde cholangiopancreatography (ERCP) was performed for CBD stone extraction and biliary stent placement. Due to continued bleeding, splenic artery embolization (SAE) was subsequently performed, achieving hemostasis while preserving splenic function. This case highlights the importance of maintaining clinical vigilance for rare but potentially fatal extrarenal complications in patients with APKD. In patients with this condition who present with abdominal pain, fever, jaundice, or unexplained anemia, splenic pathology should be considered in the differential diagnosis. Early diagnosis and timely multidisciplinary intervention, including endoscopic and interventional radiology techniques, can be life‐saving and may avoid the need for splenectomy.
SN  - 2090-6900
SN  - 2090-6919
ER  -

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