Abstract 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 References 1. Brown, H.; Sass, M.; and Cheng, P.Z.: Infectious Mononucleosis and Splenic Rupture: Report of a Case , Ohio Med J 60:954-995 ( (Oct) ) 1964. 2. McClure, J.N., Jr.: Spontaneous Rupture of the Spleen in Infectious Mononucleosis: A Case Report , Amer Surg 26:776-777 ( (Dec) ) 1960. 3. Gilbert, R.A.; Goldzicher, J.W.; and Cook, T.A., Jr.: Insidious Rupture of the Spleen or Splenic Vessels Associated With Pregnancy , J Abdom Surg 6:48-57 ( (May) ) 1964. 4. Flood, M.D., and Carpenter, R.A.: Spontaneous Rupture of the Spleen in Acute Myeloid Leukaemia , Brit Med J 521:35-36 ( (Jan 7) ) 1961.Crossref 5. Labree, R.H.; Fuller, J.; and Boman, P.G.: Spontaneous Rupture of the Spleen After Acute Pancreatitis , JAMA 122:816-817 ( (Feb 20) ) 1960.Crossref 6. Husni, E., and Turell, D.: Spontaneous Rupture of the Normal Spleen: Does It Occur Without Trauma or Antecedent Disease? Arch Surg 83:286-290 ( (Aug) ) 1961.Crossref 7. Orloff, M.J., and Peskin, G.W.: Spontaneous Rupture of the Normal Spleen; A Surgical Enigma , Int Abstr Surg in Surg Gynec Obstet 106:1-11 ( (Jan) ) 1958. 8. Sparkman, R.: Rupture of the Spleen in Pregnancy: Report of Two Cases and Review of Literature , Amer J Obstet Gynec 76:587-598 ( (Sept) ) 1958. 9. Embery, M.P., and Painter, N.S.: Haemopertoneum Due to Spontaneuos Rupture of the Spleen During Pregnancy , Brit J Surg 49:575-576 ( (March) ) 1962.Crossref 10. O'Brien, S.E.: Spontaneous Rupture of the Spleen in Pregnancy , Canad Med Ass J 89:667-668 ( (Sept 28) ) 1963. 11. Diguillo, V.S., et al: Spontaneous Splenic Rupture in Early Pregnancy , Obstet Gynec 2:725-727 ( (June) ) 1958. 12. Kobak, A.J., et al: Ruptured Spleen Simulating Ectopic Pregnancy , Amer J Obstet Gynec 67:422, 1954.
Archives of Surgery – American Medical Association
Published: Jan 1, 1966