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Computed topography (CT) scan of the abdomen and pelvis with IV contrast showing haemoperitoneum with blood clot adjacent to spleen suggestive of rupture.
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Intraoperative finding of a grossly enlarged spleen with a ruptured large subcapsular hematoma.
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Exploratory laparotomy showed a large amount of blood (1.5 liters) and a grossly enlarged spleen with a ruptured large subcapsular hematoma (Fig. 2).
Histopathology: Spleen showed hematoma/hemorrhage (left) with slight red pulp expansion (right). H&E (Taken by Dr Manal Abdulrahim).
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Microscopically hemorrhage was confirmed together with slight red pulp expansion (Fig. 3) and foci of brown/black pigment in macrophages (Fig. 4).