A Rare Case of Atraumatic Splenic Rupture Following Cocaine Use

¹MAJD Abdessamad, ²AMOR Ayoub, ³BERRADA Othmane, ⁴ETTAOUSSI Abdelhak, ⁵KAMAL Khadija, ⁶BOUALI Mounir, ⁷EL BAKKOURI Abdelhak, ⁸EL HATTABI Khalid

^{1,2,3,4,5,6,7,8}Department of Surgical Emergencies, IBN ROCHD University Hospital of Casablanca, Casablanca, Morocco.

DOI: 10.58806/ijhmr.2025.v4i8n02

ABSTRACT

Cocaine abuse is common among patients presenting to the emergency department. While the cardiovascular complications of cocaine are well recognized by clinicians, awareness of its abdominal complications—such as bowel ischemia and splenic rupture—remains limited. We report the case of a 52-year-old male with a history of cocaine use who presented with sudden- onset left upper quadrant abdominal pain. Imaging revealed an atraumatic splenic rupture with associated hemoperitoneum. After excluding other possible causes, particularly neoplastic and infectious etiologies, a conservative management approach was adopted. Prompt recognition of splenic rupture is critical, as it may be difficult to diagnose clinically and can be life-threatening. Physicians should maintain a high index of suspicion and consider imaging when evaluating cocaine users with acute abdominal symptoms.

KEYWORDS

Cocaine, atraumatic splenic rupture, spontaneous splenic rupture.

REFERENCES

1) Khan, A. N., Casaubon, J. T., Paul Regan, J., & Monroe, L. (2017). Cocaine- induced splenic rupture. Journal of Surgical Case Reports, 2017(3), rjx054. https://doi.org/10.1093/jscr/rjx054
2) Lee Ramos, J., Farr, M., Shin, S. H., & Ahmed, N. (2019). Atraumatic splenic rupture in young adult following cocaine use. International Journal of Surgery Case Reports, 65, 168‑170.

https://doi.org/10.1016/j.ijscr.2019.10.081
3) Marketing, A., Director of Digital. (2024, novembre 29). Cocaine Vasoconstriction. Banyan Treatment Center. https://www.banyantreatmentcenter.com/blog/cocaine-vasoconstriction/
4) Renzulli, P., Hostettler, A., Schoepfer, A. M., Gloor, B., & Candinas, D. (2009a). Systematic review of atraumatic splenic rupture. The British Journal of Surgery, 96(10), 1114‑1121.

https://doi.org/10.1002/bjs.6737
5) Renzulli, P., Hostettler, A., Schoepfer, A. M., Gloor, B., & Candinas, D. (2009b). Systematic review of atraumatic splenic rupture. British Journal of Surgery, 96(10), 1114‑1121.

https://doi.org/10.1002/bjs.6737