Abstract: Objective To investigate the clinical manifestation, diagnosis and treatment of spontaneous splenic rupture. Methods Patients with splenic rupture treated by the department of general surgery of the First Affiliated Hospital of Soochow University from January 2007 to December 2018 were collected. Data of patients with spontaneous splenic rupture were analyzed including the etiology, clinical manifestations, auxiliary examination, treatment and postoperative pathology retrospectively. Results A total of 187 cases of splenic rupture were treated during this period, among them 13 cases (6.95%) were spontaneous splenic rupture. The main clinical manifestations were sudden left upper abdominal pain without obvious inducement. All the laboratory tests showed different degrees of low hemoglobin. Splenic rupture with hemoperitoneum was diagnosed by B ultrasound or CT examination. After conservative treatment failed, 1 patient underwent splenectomy, 1 patient underwent laparoscopic splenectomy after emergency DSA embolization for hemostasis, and all the other 11 patients underwent emergency splenectomy. There were 6 cases of malignant tumor, 1 case of thrombotic splenomegaly, 3 cases of congestive splenomegaly and 3 cases of idiopathic splenic rupture. Twelve patients were discharged successfully, and one patient died after automatic discharge due to the postoperative hemorrhage. Conclusion Spontaneous splenic rupture has insidious clinical manifestations and dangerous conditions, requiring active surgical treatment. Pathological spleen is a common cause of spontaneous splenic rupture, and splenectomy is recommended.

Key words: splenic rupture, rupture, spontaneous, splenectomy, diagnosis and treatment, pathological spleen