Traumatic splenic rupture during 30 years. An analysis of 88 cases with special attention to delayed rupture

Eighty-eight cases of splenic rupture in non-penetrating abdominal injury are analysed. An increasing frequency was seen during the 30-year period studied (1946--1975). Teenagers and young adults were the most affected age groups. A rising incidence of traffic accidents amd multiple iinjuries was noted. Mortality was 21%. All patients with an isolated splenic rupture survived. The complication rate was low. The high incidence of delayed splenic rupture in earlier reports seems to be more a refleciton of the diagnostic diffulties than an actual delayed rupture. We have put the splenic ruptures into minor immediate, major immediate, and delayed. Minor splenic rupture was seen in 20% of patients undergoing operation, major in 75%, and delayed in only 5%. Three of our patients were operated on with splenorrhaphy with an uneventful postoperative course. In minor splenic ruptures, especially in young patients, splenorrhaphy could be a possible way of treatment but more controlled studies are needed before firm recommendations can be made.