A patient presents with left upper quadrant pain and imaging shows intraperitoneal blood with rebound tenderness. What is the suspected diagnosis?

A patient presents with left upper quadrant pain and imaging shows intraperitoneal blood with rebound tenderness. What is the suspected diagnosis?

• A. Appendicitis
• B. Pancreatitis
• C. Splenic rupture
• D. Gastritis

Answer: (C)

Splenic rupture is most likely. The spleen sits in the left upper quadrant, and when it ruptures it bleeds into the peritoneal cavity (hemoperitoneum). The presence of intraperitoneal blood on imaging plus rebound tenderness shows peritoneal irritation from that free blood, which is a classic sign of splenic injury. Other possibilities don’t fit as well: pancreatitis can cause LUQ or epigastric pain but usually isn’t accompanied by free intraperitoneal blood on imaging; appendicitis typically causes right lower quadrant pain; gastritis involves the stomach and does not usually produce hemoperitoneum. This scenario points to a splenic rupture requiring urgent assessment and management.

Splenic rupture is most likely. The spleen sits in the left upper quadrant, and when it ruptures it bleeds into the peritoneal cavity (hemoperitoneum). The presence of intraperitoneal blood on imaging plus rebound tenderness shows peritoneal irritation from that free blood, which is a classic sign of splenic injury.

Other possibilities don’t fit as well: pancreatitis can cause LUQ or epigastric pain but usually isn’t accompanied by free intraperitoneal blood on imaging; appendicitis typically causes right lower quadrant pain; gastritis involves the stomach and does not usually produce hemoperitoneum. This scenario points to a splenic rupture requiring urgent assessment and management.