[Delayed splenic rupture (author's transl)]

Splenic rupture is a common injury associated with blunt abdominal trauma. In contrast, delayed splenic rupture is less frequent and comprises about 8--28% of cases of splenic rupture. The symptom free period can last for days or weeks. The mechanism is explained as follows. A rupture of the parenchyma occurs but the spleen capsula remains intact. A hematoma forms below the capsule and causes a strong overdistension of the capsule so that a bursting and release of blood into the abdominal cavity results. The mortality rate with splenic ruptures in 6--55% and with delayed splenic ruptures 14.6%. Our experiences are reviewed. After commencement of the hemorrhage therapy must consist of treatment for shock and immediate laparotomy and splenectomy.