[Spontaneous splenic rupture due to heparin. Report of a case and review of the literature].

We describe in this report a case of spontaneous rupture of the spleen in a 68-year-old man on heparin therapy for cerebrovascular disease. This spontaneous splenic rupture is a rare complication of anticoagulant or thrombolytic therapy. Twenty cases were reported in the world medical literature. Only one case was due to heparin. The clinical presentation, which includes mainly abdominal and left shoulder pain with shock, could mimic cardiac diseases and delay or even mask the diagnosis. The mechanism of the rupture is still unknown. It is possible that altered hemostatic mechanisms may aggravate unrecognized micro trauma to provoke a rupture of the spleen. Once the rupture is suspected, the diagnosis can be confirmed with CT scan, or ultrasound. The treatment will be mainly reversal of anticoagulation and splenectomy.