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U.O. di Chirurgia Generale, Ospedale E Lotti, Pontedera, Pisa.
Spontaneous rupture of the spleen without a history of trauma is a rare clinical entity and represents a dramatic abdominal emergency. Most cases of spontaneous rupture occur in a diseased spleen (pathological spontaneous rupture). The authors present the case of a 20-year-old man who presented with pain in the left upper quadrant and clinical signs of haemorrhagic shock. The execution of focused assessment with sonography for trauma in the emergency room revealed the rupture of a pathological spleen with massive haemoperitoneum. The patient underwent emergency splenectomy. Histological examination of the spleen diagnosed infiltration of B cell lymphoma. Spontaneous rupture of the spleen must be considered in patients with acute abdominal pain and haemorrhagic shock. The role of focused assessment with sonography for trauma in the emergency room is discussed.
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