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June 12, 1943

Current Comment

JAMA. 1943;122(7):444-445. doi:10.1001/jama.1943.02840240034014

DELAYED RUPTURE OF THE SPLEEN  Delayed splenic rupture and the syndrome which accompanies it, rare in peacetime, now takes on new importance because of its potentially great increase in incidence resulting from warfare. In a recent review of this subject Zabinski and Harkins1 analyzed 66 reported cases of traumatic subcutaneous rupture of the spleen with delayed hemorrhage, including 4 of their own. Delayed splenic rupture is most common in men in the third decade in life. Falls and traffic accidents are the most common etiologic agents. About 50 per cent of the secondary ruptures occur after intervals of less than seven days, while in an additional 25 per cent the latent period ends during the second week. Fractured ribs on the left side occur in about 10 per cent of the cases. Kehr's sign (pain in the left shoulder due to irritation of the phrenic nerve) is present in