Clinical features of a ruptured spleen:
(1) left upper quadrant abdominal pain
(2) left upper quadrant tenderness
(3) left upper quadrant rigidity
(4) left shoulder tip pain
(5) signs of hemorrhage (pallor, tachycardia, hypotension, oliguria)
(6) shock if intraperitoneal hemorrhage is severe
(7) variable abdominal distention
(8) bloody fluid retrieved by peritoneal paracentesis
Imaging findings (ultrasonography may be the fastest and cheapest modality):
(1) variable splenomegaly
(2) intraperitoneal fluid and/or hematoma
