BACKGROUND: Splenic artery aneurysm is uncommon in a healthy young male patient. With spontaneous rupture, it can quickly become life-threatening. Our aim is to highlight the possibility of splenic artery aneurysm among healthy young patients and its presentation as recurrent abdominal pain, while pending rupture is possible, which can present a diagnostic challenge. The rare occurrence and spontaneous rupture of a splenic artery aneurysm are often fatal outside an inpatient setting.

CASE REPORT: Here, we present the case of a 32-year-old patient who visited the Emergency Department with recurrent epigastric pain. While undergoing inpatient evaluation, had a spontaneous rupture of a splenic artery aneurysm with hypovolemic shock and a double-rupture phenomenon, necessitating emergency surgery.

CONCLUSIONS: With advances in modern imaging in recent years, the incidence of splenic aneurysm has increased 7-fold; therefore, being informed and considering it in the differential diagnosis might provide a window of opportunity and save lives.

Keywords: Aneurysm, Ruptured, Diagnosis, Differential, Splenectomy, Splenic Artery, Abdominal Pain, Pancreatectomy, Rupture, Spontaneous, Tomography, X-Ray Computed