Spontaneous splenic rupture. The role of nonoperative management.

Spontaneous splenic rupture associated with infectious mononucleosis is an infrequent occurrence. Splenectomy has been advocated as the appropriate treatment for these patients. Recently, three patients with spontaneous splenic rupture were successfully treated at our institution without surgery. Management of spontaneous splenic rupture in 37 other patients in the literature was reviewed. Nine of these patients also were treated nonoperatively. Although it has been suggested that splenectomy is the treatment of choice for patients with spontaneous splenic rupture, we believe selective nonoperative treatment of these patients is a realistic and safe option if it is employed appropriately.