Spontaneous Splenic Rupture in Severe Acute Pancreatitis: A Rare Life-Threatening Complication and Its Successful Management.

The severity of acute pancreatitis ranges from mild discomfort to severe illness with significant complications. While most cases resolve with supportive care, severe acute pancreatitis may lead to rare but serious issues such as spontaneous splenic rupture. A 46-year-old female with a history of alcohol use, hypertension, depression, and anxiety presented with persistent abdominal pain, nausea, and vomiting. Initial imaging revealed acute pancreatitis with peripancreatic fluid collections. Despite conservative management, her symptoms persisted. She experienced sudden worsening of abdominal pain and a significant drop in hemoglobin levels. Imaging confirmed a spontaneous splenic rupture with a large subcapsular hematoma and hemoperitoneum. She underwent splenic artery embolization to control the bleeding and received blood transfusions for anemia. Her condition improved with supportive care, and she was discharged with plans for outpatient follow-up. Spontaneous splenic rupture is a rare complication of acute pancreatitis resulting from the close anatomical relationship between the pancreas and spleen. Mechanisms behind it include direct enzymatic damage, pseudocyst extension, vascular injury, and increased pressure from splenic vein thrombosis. Early recognition is crucial for timely intervention. Clinicians should consider splenic complications when patients with pancreatitis exhibit sudden clinical deterioration or unexplained anemia. Prompt imaging and appropriate management can improve outcomes. Understanding the potential complications of severe pancreatitis is essential for effective patient care.