Western trauma association blunt splenic injury algorithm is useful in spontaneous rupture of a normal spleen

A focused ab- dominal ultrasonography for trauma revealed a large hemoperitoneum. Because of persistent hemodynamic instability despite ongoing resuscitation (WTA splenic injury algorithm points B and E, Fig. 1), he was taken to the operating room and underwent splenectomy and lymph node biopsy. Recent studies show that nonoperative management may be safe in a monitored setting with CT diagnosis, minimal transfusion in he- modynamically stable patients with preexisting path- ologic splenomegaly, and isolated splenic disruptions diagnosed by CT scan.4 Spontaneous rupture of a normal spleen poses a di- agnostic dilemma with differential diagnoses including myocardial infarction, pulmonary embolism, and rup- tured ectopic pregnancy.