Spontaneous splenic rupture (SSR) (also known as atraumatic splenic rupture) is rare, especially when compared to traumatic splenic rupture.
Pathology
The pathogenesis of atraumatic splenic rupture is not well understood. Splenomegaly is present in almost all patients (~95%), although the rupture of normal spleens (both in size and underlying histology) has been reported 3.
Aetiology
There is a wide range of underlying causes 1,2:
- haematological malignancies, e.g. lymphoma, leukaemia (~15%)
- infections (~15%)
- viral, e.g. infectious mononucleosis, cytomegalovirus
- bacterial, e.g. infective endocarditis, tuberculosis
- parasitic, e.g. malaria
- local inflammatory disorders, e.g. pancreatitis (~10%)
- infectious mononucleosis (less than .5%) 7
- non-malignant haematological disorders, e.g. Langerhans cell histiocytosis
- primary splenic neoplasms, e.g. angiosarcoma, haemangioma
- amyloidosis (primary and secondary)
- post-colonoscopy 4
- sneezing 5
- sarcoidosis 6
Radiographic features
Features are similar to splenic trauma with haemoperitoneum and perisplenic haematoma. The spleen is more likely to be enlarged in atraumatic ruptures 3.
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