TRAUMATIC rupture of the spleen is a common occurrence these days, and apart from signs of hemorrhagic shock and peritoneal irritation, telltale external bruises and rib fractures commonly point to a preoperative diagnosis.
Nontraumatic rupture of the spleen, much less commonly seen, is often associated with systemic diseases which are known to affect the spleen directly or indirectly; infectious mononucleosis,1,2 malaria,3 typhoid, leukemia,4 sarcoidosis, acute pancreatitis,5 etc. Quite often, awareness of this association aids in establishing the correct preoperative diagnosis.
However, a spontaneous rupture of the spleen without antecedent trauma or systemic disease is a rarity, and rarely is the correct diagnosis made preoperatively. Many authors dispute the existence of "spontaneous splenic rupture."3,6,7 Gilbert3 substitutes "insidious splenic rupture," implying antecedent trauma sufficiently remote to be forgotten by the patient, but nonetheless severe enough to establish the pathological process that leads to delayed splenic rupture