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September 1964

Occult Rupture of the Spleen

Author Affiliations

Honorary Consultant, Carswell Air Force Base Hospital, Fort Worth, Tex.

Arch Surg. 1964;89(3):434-440. doi:10.1001/archsurg.1964.01320030024004

Rupture of the spleen implies a surgical emergency—a patient in shock with active and profuse intraperitoneal bleeding which must be controlled as a life-saving procedure. These circumstances are, of course, by no means always present in splenic rupture. In some 15%1 the onset of hemorrhage is delayed from several days to a week, but when delayed rupture occurs, the same serious set of circumstances is present and requires emergency splenectomy. In others, associated injuries producing unconsciousness and shock mask the signs, and the splenic injury goes undiagnosed, and yet the patient survives. In still others, the signs and symptoms are so mild that the diagnosis can be made only after repeated observation of the patients. These facts indicate that there are a certain number of patients who survive major rupture of the spleen undiagnosed and untreated. They have an entity which will be referred to as occult rupture of

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