Autotransplantation of the Spleen Following Atraumatic Splenic Rupture Secondary to Infectious Mononucleosis: A Case Report

Atraumatic splenic rupture (ASR) is a rare and life-threatening condition that presents diagnostic difficulties due to its rarity and non-specific clinical symptoms. It often requires computed tomography (CT) imaging for accurate diagnosis and surgical planning. Splenectomy is the standard treatment for unstable patients, but autotransplantation of splenic tissue may reduce the lifelong risks of overwhelming post-splenectomy infections (OPSI) by preserving some immunological function. However, autotransplantation is rarely performed in ASR due to the delicate nature of the spleen and the presence of underlying pathology. This report describes a 27-year-old male with unstable ASR secondary to Epstein-Barr virus (EBV) infection, a condition linked to splenomegaly and rupture in 0.1-0.5% of cases. The patient underwent emergency splenectomy and autotransplantation of viable splenic tissue into the omentum. Despite the challenges associated with autotransplantation in ASR, the procedure was successful, with the patient achieving excellent recovery and remaining complication-free at the 12-month follow-up. This case illustrates the potential role of autotransplantation in ASR and highlights the need for further research to refine management strategies and improve outcomes.