Abdominal complaints in patients with infectious mononucleosis should alert the surgeon to the potential, and possibly fatal, risk of splenic rupture. Radiologic evaluation by ultrasonography and computed tomography is indicated for appropriate management. We describe a case in which a diagnosis of splenic rupture occurring spontaneously on a background of infectious mononucleosis was made as a result of a high index of suspicion. The patient was treated conservatively.

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