Nontraumatic rupture may occur in:
(1) histologically normal spleen ("spontaneous")
(2) spleen with an underlying pathologic process ("pathologic")
Factors in a pathologic process contributing to rupture:
(1) moderate to marked splenomegaly
(2) increased intrasplenic pressure
(3) tissue necrosis or breakdown
(4) thromboembolism
Infections associated with splenic rupture:
(1) malaria
(2) infectious mononucleosis
(3) infectious emboli from bacterial endocarditis
Tumors associated with splenic rupture:
(1) hairy cell leukemia, other leukemia or malignant lymphoma
(2) metastatic cancer
(3) vascular tumor of the spleen
(4) other splenic tumor
Other conditions associated with splenic rupture:
(1) dialysis
(2) amyloidosis
(3) thromboembolic disorders
Differential diagnosis:
(1) trauma that was not recognized (unconscious, intoxicated)
(2) trauma that is denied
