Spontaneous splenic rupture due to marginal zone lymphoma

An 81-year-old man collapsed at home after complaining of left upper quadrant (LUQ) abdominal pain and presented to the local hospital. He was hypotensive on arrival, but stabilized with transfusion of 2 units of packed red blood cells. His abdominal examination was significant for LUQ tenderness with no signs of peritonitis. Abdominal CT scan (figure 1) revealed splenomegaly with grade 3 splenic injury and moderate hemoperitoneum. Blood work was significant for anemia and elevated creatinine (Cr 1.9？mg/dL). Spontaneous splenic rupture (SRS) was suspected and the patient was transferred to the nearest level 1 trauma center for management