The Havoc of a Giant Spleen

We present a case of a 50-year-old female with previously diagnosed Felty's syndrome who experienced a number of complications related to massive splenomegaly including cytopenias. The patient required multiple hospitalizations during which a splenic infarction and splenothoracic fistula were discovered. Ultimately, the patient underwent splenectomy which was further complicated by post-operative multi-vein thrombosis. Analysis of this patient provides an illustration of the potential for significant morbidity and mortality associated with the often ignored finding of splenomegaly that is rarely reported in current literature.