What characterizes the presentation of splenic rupture in the context of infectious mononucleosis?

The presentation of splenic rupture in the context of infectious mononucleosis is characterized primarily by severe left upper quadrant pain. In infectious mononucleosis, which is often caused by the Epstein-Barr virus, the spleen can become enlarged due to hyperplasia of the lymphatic tissue. This enlargement makes the spleen more susceptible to rupture, especially following activities that increase abdominal pressure or trauma.

When a splenic rupture occurs, the patient typically experiences sudden and severe pain in the left upper quadrant due to bleeding into the peritoneal cavity or direct damage to the splenic tissue. This pain can be sharp and may be accompanied by additional symptoms such as hypotension or signs of internal bleeding. The severity of the pain is a key indication in recognizing splenic rupture, distinguishing it from other forms of abdominal pain that may be less intense or different in quality.

In cases of splenic rupture associated with infectious mononucleosis, the presentation is acute and intense rather than gradual, which helps differentiate it from other potential causes of abdominal discomfort.