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Spontaneous splenic haemorrhage — RCPSC EM MCQ

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HardGI/Abdominal emergenciesSpontaneous splenic haemorrhageRCPSC EM

A 62-year-old man with atrial fibrillation presents with sudden left-sided abdominal pain and syncope. Blood pressure is 86/50 mmHg and haemoglobin is 74 g/L. CT shows a large splenic subcapsular haematoma without trauma history. What is the most appropriate next step?

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Reveal the answer and explanation

Correct answer: C — Resuscitate with blood products, reverse anticoagulation if relevant and consult surgery/interventional radiology urgently

Spontaneous splenic rupture or major splenic haemorrhage presents with shock and severe abdominal pain. Management is haemorrhage control with resuscitation, reversal when indicated and urgent procedural consultation.

Reference: Rosen's Emergency Medicine; Thrombosis Canada anticoagulant reversal guidance