RESUMEN
Atraumatic or spontaneous splenic rupture is a rare but life-threatening complication of infectious mononucleosis. We present a case of a 26-year-old man presenting with a 1-week history of sharp epigastric and right upper quadrant pain, associated with malaise and subjective fever. Although initial findings were concerning for acute cholangitis, abdominal computed tomography angiography scan revealed splenic rupture. Further exploration confirmed acute Epstein-Barr virus infection. Infectious mononucleosis must be considered in young patients with lymphocytosis, splenomegaly, and prolonged malaise. Awareness of this presentation will allow for timely diagnosis and treatment, thereby preventing potentially fatal complications of infectious mononucleosis such as splenic rupture.
RESUMEN
Sevelamer, a nonabsorbable dietary phosphate binder, is essential for patients with renal impairment since hyperphosphatemia is associated with an increase in all-cause mortality. Sevelamer is generally well tolerated; however, it is rarely been documented to cause gastrointestinal mucosal injury by forming sevelamer crystals and depositing within the gastrointestinal walls. We present a 35-year-old man with end-stage renal disease on peritoneal dialysis who developed abdominal pain and hematochezia. Initial imaging and endoscopic examination were concerning for ischemic enteritis, and histopathology revealed crystalloid structures surrounded by necrosis consistent with sevelamer-induced ischemic enteritis.