Background: Splenic injury is normally associated with trauma, but spontaneous splenic rupture has been described in various systemic diseases.
Case presentation: A 56-year-old male on oral anticoagulation presented to the emergency department with epigastric pain, nausea, and left upper quadrant tenderness. There was no history of trauma. Contrast-enhanced CT imaging revealed a large subcapsular haematoma of the spleen. Oral anticoagulation was antagonised with vitamin K and the patient was discharged in good condition after 3 days of clinical observation.
Conclusion: Non-traumatic splenic rupture is a rare complication of oral anticoagulation.