• J Emerg Med · May 2000

    Case Reports

    Spontaneous splenic rupture due to subcutaneous heparin therapy.

    • S J Weiss, T Smith, E Laurin, and D H Wisner.
    • Division of Emergency Medicine, University of California, Davis, Medical Center, Sacramento, California 95817, USA.
    • J Emerg Med. 2000 May 1;18(4):421-6.

    AbstractWe report a case of spontaneous splenic rupture in a 59-year-old woman who was receiving 15,000 units of heparin subcutaneously (s.c. ) twice a day for deep venous thrombosis (DVT) prophylaxis. Her past medical history included multiple DVT, pulmonary emboli, and ovarian cancer stage III-C with known ascites. The diagnosis of splenic rupture was initially missed because of the ascites. This case illustrates both a previously undescribed complication of s.c. heparin therapy and a failure of ultrasound diagnosis. We emphasize the unique presentation, difficulty in diagnosis, and need for early surgical involvement to ensure the most favorable outcome.

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