Spontaneous Nontraumatic Rupture Research Articles

SPONTANEOUS RUPTURE OF THE DISEASED SPLEEN

INTRA-ABDOMINAL 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 intra-abdominal hemorrhage, are (1) rupture of an abdominal aneurysm; (2) rupture of a splanchnic vessel in patients with arteriosclerosis (abdominal apoplexy),1and (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,2in

NONTRAUMATIC SPONTANEOUS RUPTURE OF THE SPLEEN

NONTRAUMATIC spontaneous rupture of an apparently normal spleen, considered by some as an impossibility, is indeed a rarity. Ask-Upmark 1 studied a total of 120 cases of rupture of the spleen, and it included only 2 cases in which the history was absolutely negative regarding trauma. One of the cases concerned a 43 year old man in whom the ruptured spleen was macroscopically normal. No microscopic examination was made. The other case was that of a 30 year old man. The ruptured spleen weighed 250 Gm., and it contained no coagula. The microscopic examination showed hyalinization of the arterioles and increase of stroma. Ask-Upmark concluded that a spontaneous rupture of a normal spleen is possible, explaining it on a basis of a functional lienal apoplexy. Zuckerman and Jacobi 2 reported a case of genuine spontaneous rupture of a normal spleen in a 29 year old woman, with a report of