Spontaneous splenic rupture in imported Plasmodium ovale malaria: a case series of three patients
- 1Department of Surgery, Mohammed V Military Training Hospital, Rabat, Morocco
Abstract
Introduction and importance:: Spontaneous splenic rupture (SSR) is a rare but life-threatening complication of malaria, most commonly associated with Plasmodium falciparum and Plasmodium vivax. Although Plasmodium ovale is less frequently implicated, severe splenic complications have increasingly been recognized. Early diagnosis and prompt management are essential for reducing morbidity and mortality.
Case presentation:: We report a retrospective case series of three male patients who developed SSR secondary to imported P. ovale malaria after returning from sub-Saharan Africa. All patients were managed at a Moroccan military surgical referral center and presented with acute abdominal symptoms and hemodynamic instability. Diagnosis was established through imaging and confirmed by intraoperative findings. Emergency laparotomy with splenectomy was performed in all cases, with favorable postoperative outcomes. Histopathological examination revealed red pulp congestion and malarial pigment deposition.
Clinical discussion:: Malaria-related SSR is an uncommon but severe complication that may occur even with species traditionally considered less virulent, such as P. ovale. The pathophysiology involves splenic congestion, cellular hyperplasia, and increased intrasplenic tension, predisposing the spleen to rupture. Because symptoms may mimic other acute abdominal emergencies, diagnosis can be delayed. In hemodynamically unstable patients, splenectomy remains the treatment of choice. This series emphasizes the importance of considering SSR in travelers and military personnel returning from malaria-endemic regions.
Conclusion:: Plasmodium ovale malaria can lead to severe and potentially fatal splenic complications. Early recognition of SSR and prompt surgical management are crucial to achieving favorable outcomes. Awareness of this complication should be maintained in military and referral healthcare settings that manage imported malaria cases.
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BibTeX
@article{dabbagh2026spontaneous,
title = {{Spontaneous splenic rupture in imported Plasmodium ovale malaria: a case series of three patients}},
author = {Mahmoud Dabbagh and Amine Maazouz and Hakim El Kaoui and Sidi Mohammed Bouchentouf and Mountassir Moujahid},
journal = {International Journal of Surgery Case Reports},
year = {2026},
month = oct,
doi = {10.1097/rc9.0000000000001152},
url = {https://doi.org/10.1097/rc9.0000000000001152},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Spontaneous splenic rupture in imported Plasmodium ovale malaria: a case series of three patients
AU - Mahmoud Dabbagh
AU - Amine Maazouz
AU - Hakim El Kaoui
AU - Sidi Mohammed Bouchentouf
AU - Mountassir Moujahid
PY - 2026
DA - 2026/10/21
JO - International Journal of Surgery Case Reports
DO - 10.1097/rc9.0000000000001152
UR - https://doi.org/10.1097/rc9.0000000000001152
AB - Introduction and importance:: Spontaneous splenic rupture (SSR) is a rare but life-threatening complication of malaria, most commonly associated with Plasmodium falciparum and Plasmodium vivax. Although Plasmodium ovale is less frequently implicated, severe splenic complications have increasingly been recognized. Early diagnosis and prompt management are essential for reducing morbidity and mortality. Case presentation:: We report a retrospective case series of three male patients who developed SSR secondary to imported P. ovale malaria after returning from sub-Saharan Africa. All patients were managed at a Moroccan military surgical referral center and presented with acute abdominal symptoms and hemodynamic instability. Diagnosis was established through imaging and confirmed by intraoperative findings. Emergency laparotomy with splenectomy was performed in all cases, with favorable postoperative outcomes. Histopathological examination revealed red pulp congestion and malarial pigment deposition. Clinical discussion:: Malaria-related SSR is an uncommon but severe complication that may occur even with species traditionally considered less virulent, such as P. ovale. The pathophysiology involves splenic congestion, cellular hyperplasia, and increased intrasplenic tension, predisposing the spleen to rupture. Because symptoms may mimic other acute abdominal emergencies, diagnosis can be delayed. In hemodynamically unstable patients, splenectomy remains the treatment of choice. This series emphasizes the importance of considering SSR in travelers and military personnel returning from malaria-endemic regions. Conclusion:: Plasmodium ovale malaria can lead to severe and potentially fatal splenic complications. Early recognition of SSR and prompt surgical management are crucial to achieving favorable outcomes. Awareness of this complication should be maintained in military and referral healthcare settings that manage imported malaria cases.
SN - 2210-2612
ER -