Occult rupture of the spleen

Five cases of occult or 'spontaneous' rupture of the spleen are described. Pathological examination of the spleen showed changes of infectious mononucleosis in 2 cases, Hodgkin's disease in 1, amyloidosis in 1 and in the remaining spleen no underlying disease process was seen. All 5 cases survived, and evidence from the literature suggests that this may have been in some measure due to the fact that prompt surgical treatment followed a correct preoperative diagnosis. The importance of awareness of the condition, radiological investigation and peritoneal lavage in reaching the correct diagnostic conclusion is discussed.