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Delayed splenic rupture is a rare but well recognised clinical phenomenon with significant morbidity and mortality. We describe an 84-year-old woman with persistent unexplained anaemia requiring transfusion following a fractured neck of femur. One month after hemiarthroplasty, she collapsed and became haemodynamically unstable with profound anaemia. Computed tomography of the abdomen revealed splenic haematoma with haemoperitoneum, with splenic rupture confirmed at the post-mortem examination. This case demonstrates the difficulty in diagnosing delayed splenic rupture in older people with non-specific symptoms, and the need for both comprehensive trauma assessment and a high index of clinical suspicion in patients with persistent anaemia after trauma.

A rare cause of anaemia in an older patient with fractured neck of femur