A 76-year-old woman presented to the accident and emergency department with an acute surgical abdomen. She did not have any significant medical history or history of trauma. Examination findings revealed generalized peritonitis. Preliminary investigations were unhelpful in revealing a cause. On urgent exploratory laparotomy, a ruptured spleen was found and splenectomy performed. The hollow viscera were normal. The gross and microscopic appearances were suggestive of splenic rupture occurring through areas of infarction. We proceed to analyse the causes of spontaneous rupture of the spleen in our discussion of this case.
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