Renzulli P Hostettler A Schoepfer AM Gloor B Candinas D 2009 BACKGROUND Atraumatic splenic rupture (ASR) is an ill defined clinicopathological entity. METHODS The aim was to characterize aetiological and risk factors for ASR-related mortality in order to aid disease classification and treatment. A systematic literature review (1980-2008) was undertaken and logistic regression analysis employed. RESULTS Some 632 publications reporting 845 patients were identified. The spleen was normal in 7.0 per cent (atraumatic-idiopathic rupture). One, two or three aetiological factors were found in 84.1, 8.2 and 0.7 per cent respectively (atraumatic-pathological rupture). Six major aetiological groups were defined: neoplastic (30.3 per cent), infectious (27.3 per cent), inflammatory, non-infectious (20.0 per cent), drug- and treatment-related (9.2 per cent) and mechanical (6.8 per cent) disorders, and normal spleen (6.4 per cent). Treatment comprised total splenectomy (84.1 per cent), organ-preserving surgery (1.2 per cent) or conservative measures (14.7 per cent). The ASR-related mortality rate was 12.2 per cent. Splenomegaly (P = 0.040), age above 40 years (P = 0.007) and neoplastic disorders (P = 0.008) were associated with increased ASR-related mortality on multivariable analysis. CONCLUSION The condition can be classified simply into atraumatic-idiopathic (7.0 per cent) and atraumatic-pathological (93.0 per cent) splenic rupture. Splenomegaly, advanced age and neoplastic disorders are associated with increased ASR-related mortality. https://sonar.ch/global/documents/218808 eng info:eu-repo/semantics/altIdentifier/doi/10.1002/bjs.6737 info:eu-repo/semantics/altIdentifier/pmid/19787754 The British journal of surgery. - 2009 Adult Aged Aged, 80 and over Epidemiologic Methods Female Humans Male Middle Aged Rupture, Spontaneous Splenic Rupture Splenomegaly Young Adult Systematic review of atraumatic splenic rupture. http://purl.org/coar/resource_type/c_6501