Introduction: Hemodynamic instability in previously stable trauma patients carries rather not a wide differential diagnosis. Delayed Splenic Rupture is certainly not on the top of the list.

Case Presentation: We present a patient with delayed splenic rupture eight days after a blunt abdominal trauma caused by a motor vehicle accident. The patient's initial full-body trauma protocol CT scan was negative for internal injuries and rib fractures. He was discharged after 48 h of uneventful observation. Returning eight days with grade III subcapsular splenic hematoma; with negative history of strenuous activities or a second trauma. A trial of non-operative management was opted for after stabilizing the patient. However, the patient's hemodynamic status deteriorated and he was operated on a couple of hours after presentation.

Discussion: Delayed splenic rupture remains a rare diagnosis with an open time window for presentation. While it is a rare entity, delayed splenic rupture increases the mortality rate in an otherwise non-mortal injury.

Conclusion: This case presents an important educational value in bringing forth such rare diagnoses in trauma patients and highlights the management transition from a non-operative approach to an operative one.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362288PMC
http://dx.doi.org/10.1016/j.ijscr.2023.108474DOI Listing

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