Summary

Traumatic rupture of the spleen is a well known problem, complicating many types of abdominal injury. In contrast, a spontaneous rupture is a rare occurrence, mainly associated with a large spleen resulting from infections, the most common in this country being infectious mononucleosis. It is also a rare complication of leukaemias and lymphomas and the case presented here demonstrates a peculiar diagnostic problem. Case report First admission A 28-year-old journalist presented to this hospital in October 1973 with symptoms of anaemia. There was no history of a bleeding diathesis, infection or significant past or family history. Examination showed a thin man, anaemic, not icteric, with a liver palpable 5 cm below the right costal margin and a spleen 11 cm below the left costal margin. There was no lymphadenopathy. There were two small retinal haemorrhages present, one in each eye