Ruptured spleen.

Splenic rupture is a common intra-abdominal injury and is usually diagnosed without difficulty by clinical examination alone. It is in patients with multiple injuries, especially if they are unconscious, that there may be a delay in diagnosis unless the condition is carefully sought. Peritoneal lavage is the most helpful diagnostic aid in difficult cases. Urgent laparotomy is required as soon as splenic rupture is diagnosed and in most cases splenectomy is a life-saving procedure. However, the asplenic state carries small but measurable risks, especially for children. Surgeons dealing with abdominal trauma should familiarize themselves with the techniques of splenic repair so that these can be safely applied to certain selected cases.