Sleeve gastrectomy is one of the commonest bariatric procedures performed globally with an acceptable rate of reported complications. Splenic injury during this procedure is a rare but can be a serious complication. A 32-year-old male patient who had a spontaneous splenic rupture two weeks after an uneventful sleeve gastrectomy needed an emergency splenectomy. Spontaneous rupture after sleeve gastrectomy is an extremely rare condition with one single previous report. Diagnosis needs a high clinical suspicion and treatment is usually by splenectomy if not responding to resuscitative measures. Such cases need adequate further workup to exclude other causes of rupture. Considering the high number of sleeve gastrectomy procedures done worldwide, this report highlights the importance of high suspicion and awareness of physicians who face patients with post-bariatric complications. Early diagnosis and intervention are usually important factors in better outcome.
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