Splenic rupture following thrombolysis treatment for acute myocardial infarction

Thrombolysis is the gold standard of treatment for acute myocardial infarction (MI), however can be associated with haemorrhagic complications. To date, splenic rupture following thrombolysis has only been reported in those with an associated history of major trauma or splenomegaly. We report a case of a 47-year old female who developed splenic rupture following thrombolysis treatment with no history of trauma or splenomegaly. She received Tenecteplase therapy for an inferior MI, and six hours later she developed upper abdominal pain and hypotension. CT showed large haemoperitoneum with a large peri-splenic haematoma. She subsequently underwent a laparotomy and splenectomy. Patient remained well and was discharged home eight days postoperatively.