Spontaneous rupture of a normal spleen is a rare event; its acceptability as a definite clinical entity has created considerable controversy.1,13,14,23,27,29 In their excellent treatise on the subject, Orloff and Peskin19 elaborated upon certain criteria that should be satisfied before a rupture of the spleen may be considered "spontaneous," stressing the absence of trauma, perisplenic adhesions, or disease that might adversely affect the spleen, and the lack of a preexistent anatomic abnormality within the substance of the spleen. Using these criteria the authors rejected 43 of the 71 cases (60%) reported during the last 6 decades as spontaneous ruptures of the spleen.
In the absence of objective evidence of disease or structural abnormality directly or indirectly affecting the spleen, the acceptability of a case as spontaneous rupture rests entirely upon a negative history of trauma, that is, upon the reliability of the patient's memory of possible contributing events.
HUSNI EA, TURELL D. Spontaneous Rupture of the Normal SpleenDoes It Occur Without Trauma or Antecedent Disease?. Arch Surg. 1961;83(2):286-290. doi:10.1001/archsurg.1961.01300140128024