Unsuspected splenic rupture in a neonate

Serious intra-abdominal injuries in neonates are very rare. In addition, th e signs and symptoms of hemoperitoneum caused by bleeding from solid viscer a are vague and nonspecific and often are not recognized before the onset o f hypovolemic shock or death. In this report, we describe a 2-day-old infan t who presented with shock and pallor who had a ruptured spleen. presumably from birth. We also review the literature and the importance of recognizin g this injury in the emergency department setting.