A second look at delayed splenic rupture.

From 1968 to 1976, 314 patients were treated by splenectomy for blunt splenic injuries. Three hundred four of these were operated on within 24 hours. All had typical splenic lacerations with intraperitoneal bleeding from the time of injury. This was true also of seven of the ten operated on after 24 hours. In only three of this late group was the evidence in favor of possible delayed rupture of a subcapsular hematoma. These data support our conclusion that delayed rupture is an unusual sequel to blunt splenic trauma, and that most patients thought to have delayed rupture of the spleen have, instead, delayed recognition of splenic rupture.