Delayed rupture or delayed diagnosis of rupture of the spleen

Delayed rupture of the spleen was seen in only six of 302 patients undergoing splenectomy for splenic injury following blunt abdominal trauma. Only one of these six patients was asymptomatic for two days following the accident. This is an incidence of 2 per cent delayed rupture as compared with the 15 per cent quoted in the literature. An aggressive approach to the diagnosis of intra-abdominal injury has helped to eliminate the delay in recognition of rupture of the spleen. Peritoneal lavage has accurately identified those patients with intra-abdominal injury. We conclude that delayed rupture of the spleen is, in reality, usually a delay in diagnosis of splenic rupture.