A Rare Case of Atraumatic Splenic Rupture Following Cocaine Use

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.