Unsuspected splenic rupture in a neonate.

Serious intra-abdominal injuries in neonates are very rare. In addition, the signs and symptoms of hemoperitoneum caused by bleeding from solid viscera are vague and nonspecific and often are not recognized before the onset of hypovolemic shock or death. In this report, we describe a 2-day-old infant who presented with shock and pallor who had a ruptured spleen, presumably from birth. We also review the literature and the importance of recognizing this injury in the emergency department setting.