A fatal case of spleen rupture secondary to thrombosed aneurysm of the splenic vein

Vascular abnormalities of the spleen are infrequently encountered in medical practice and, among these, an aneurysm of the splenic vein is a rare event, being only a few dozen cases reported to date in the literature. The rarity of this clinical condition hinders the understanding of its clinical history, related medical management and potential complications, which are currently unclear. In this article, we report an autopsy case observed in the practice of forensic medicine concerning a 45-year-old woman, anaemic, who died at home a few hours after a previous hospital evaluation for abdominal pain and vaginal spotting. The autopsy revealed a massive secondary hemoperitoneum caused by a laceration of the spleen. On examination of the organ, an aneurysm of the proximal branch of the splenic vein was detected, affected by complete thrombotic occlusion. This case offers a new perspective regarding the clinical evolution of splenic vein aneurysm to death, unprecedented in the current literature.