Atraumatic or spontaneous splenic rupture is rare, especially when compared to traumatic splenic rupture.
The pathogenesis of atraumatic splenic rupture is not well understood. Splenomegaly is present in almost all patients (~95%), although rupture of normal spleens (both in size and underlying histology) does occur 3.
There is a wide range of underlying causes 1,2:
- haematological malignancies, e.g. lymphoma, leukaemia (~15%)
- infections (~15%)
- local inflammatory disorders, e.g. pancreatitis (~10%)
- non-malignant haematological disorders, e.g. Langerhans cell histiocytosis
- primary splenic neoplasms, e.g. angiosarcoma, haemangioma
- amyloidosis (primary and secondary)
- post-colonoscopy 4
Features are similar to splenic trauma with haemoperitoneum and perisplenic haematoma. The spleen is more likely to be enlarged in atraumatic ruptures 3.
- 1. Gedik E, Girgin S, Aldemir M et-al. Non-traumatic splenic rupture: report of seven cases and review of the literature. World J. Gastroenterol. 2009;14 (43): 6711-6. Free text at pubmed - Pubmed citation
- 2. Renzulli P, Hostettler A, Schoepfer AM et-al. Systematic review of atraumatic splenic rupture. Br J Surg. 2009;96 (10): 1114-21. doi:10.1002/bjs.6737 - Pubmed citation
- 3. Mirvis SE, Soto JA, Shanmuganathan K et-al. Problem Solving in Emergency Radiology. Saunders. ISBN:B00N04AZQC. Read it at Google Books - Find it at Amazon
- 4. Steele DC, Mohamed AM, Kaza A, McCarthy D. Splenic Rupture Following Colonoscopy. Digestive diseases and sciences. 62 (1): 72-75. doi:10.1007/s10620-016-4364-2 - Pubmed
- normal appearance of the spleen
- pseudolesion of the spleen: inhomogeneous splenic enhancement
splenic lesions and anomalies
- congenital anomalies
- mass lesions
- infiltrative processes
- incidental splenic lesion (approach)