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 Spleen: Does It Occur Without Trauma or Antecedent Disease? Arch Surg. 1961;83(2):286–290. doi:10.1001/archsurg.1961.01300140128024
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