The spleen may rupture in the absence of trauma.


Nontraumatic rupture may occur in:

(1) histologically normal spleen ("spontaneous")

(2) spleen with an underlying pathologic process ("pathologic")


Factors in a pathologic process contributing to rupture:

(1) moderate to marked splenomegaly

(2) increased intrasplenic pressure

(3) tissue necrosis or breakdown

(4) thromboembolism


Infections associated with splenic rupture:

(1) malaria

(2) infectious mononucleosis

(3) infectious emboli from bacterial endocarditis


Tumors associated with splenic rupture:

(1) hairy cell leukemia, other leukemia or malignant lymphoma

(2) metastatic cancer

(3) vascular tumor of the spleen

(4) other splenic tumor


Other conditions associated with splenic rupture:

(1) dialysis

(2) amyloidosis

(3) thromboembolic disorders


Differential diagnosis:

(1) trauma that was not recognized (unconscious, intoxicated)

(2) trauma that is denied


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