INTRA-ABDOMINAL hemorrhage, regardless of the cause, remains one of the most important of all the conditions constituting acute surgical emergencies. The ultimate result is the same whether the hemorrhage results from failure of diagnosis or from an error in judgment of the optimum time for operative intervention.
With the exclusion of bleeding of a genital organ in females and bleeding due to trauma, extremely difficult diagnostic problems remain. Included in these, all of which come under the category of "spontaneous intra-abdominal hemorrhage," are (1) rupture of an abdominal aneurysm; (2) rupture of a splanchnic vessel in patients with arteriosclerosis (abdominal apoplexy),1 and (3) splenic rupture in either a normal or a diseased spleen. It is the latter of these with which this paper is primarily concerned.
Nontraumatic spontaneous rupture of an apparently normal spleen, although rare, is considered by some surgeons as a definite clinical entity. Dahle,2 in
ELLISON EH. SPONTANEOUS RUPTURE OF THE DISEASED SPLEEN. Arch Surg. 1949;59(2):289–299. doi:10.1001/archsurg.1949.01240040294011