Delayed rupture of the spleen is defined as profuse intra-abdominal hemorrhage occurring 48 or more hours after blunt trauma to the spleen, the period during the initial 48 hours following injury being relatively symptom-free. In two reports, the incidence of splenic hemorrhage was 30% of all subcutaneous abdominal injuries in 1932 and 48% in 1939.9 This was the most frequent intra-abdominal injury resulting from blunt trauma. The higher incidence of splenic trauma in 1939 may have stemmed from the increasing number and force of automobile accidents.
Immediate rupture of the spleen following blunt trauma occurs six times as frequently as does delayed rupture,9 but, with one of every six splenic ruptures presenting as a delayed hemorrhage, the need for data concerning its pathogenesis becomes apparent. The only information at present is that based on clinical impressions, as no report of experimental observations has been found.
DAVIS GW, WEBB HW, HOWARD JM. Experimental Observations on Delayed Rupture and Secondary Hemorrhage from the Spleen. AMA Arch Surg. 1957;75(1):9–12. doi:10.1001/archsurg.1957.01280130013002
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