Spontaneous splenic rupture due to subcutaneous heparin therapy

We report a case of spontaneous splenic rupture in a 59-year-old woman who was receiving 15,000 units of heparin subcutaneously (s.c.) twice a day for deep venous thrombosis (DVT) prophylaxis. Her past medical history include d multiple DVT, pulmonary emboli, and ovarian cancer stage III-C with known ascites, The diagnosis of splenic rupture was initially missed because of the ascites. This case illustrates both a previously undescribed complicati on of s.c. heparin therapy and a failure of ultrasound diagnosis. We emphas ize the unique presentation, difficulty in diagnosis, and need for early su rgical involvement to ensure the most favorable outcome, (C) 2000 Elsevier Science Inc.