On physical examination, traumatic splenic rupture may reveal generalized abdominal wall tenderness and muscle tonus, most notably in the left upper abdomen. The splenic turbid zone in the left quadrant of the rib cage is also often enlarged. If there is a large amount of blood accumulation in the abdomen, mobile turbid sounds can be found, but because there is often a clot around the spleen, the right lumbar region can be hollow when the patient is lying on the left side, but the left lumbar region often shows a fixed turbid sound when the patient is lying on the right side, which is called the Ballance sign. The spleen parenchyma is very fragile and rich in blood flow, which can easily cause rupture and bleeding when subjected to external forces. Clinically, splenic injury or rupture caused by direct or indirect external forces is called traumatic or injurious splenic rupture. Traumatic splenic rupture can be divided into open and closed. There are also spontaneous splenic rupture and medically induced splenic rupture. Open traumatic splenic rupture is most often caused by stabbing or shrapnel injuries, often accompanied by other visceral injuries, while closed traumatic splenic rupture is caused by direct or indirect violence such as falls, punches, and car accidents, and is the most common type of abdominal injury in clinical practice. The high incidence of splenic trauma can be explained by the mechanism of trauma. 1965 experiments by Gieseler demonstrated that not only direct trauma to the left side of the abdomen can cause splenic injury, but also indirect blows can cause splenic trauma. The tight union of the spleen with the gastric wall and the tight fixation of the surrounding ligaments restrict the sudden movement of the spleen, especially when the intra-abdominal pressure increases dramatically, the upper and lower poles of the spleen are very narrow, and the diaphragmatic surface is curved into an extremely convex form, while the base of the spleen is hyperextended, making the spleen very vulnerable to transection. In case of trauma, the pressure in the spleen and the pressure in the stomach are increased, while the increased blood storage in the spleen leads to an increased possibility of injury. Indirect impact during pregnancy may also cause sudden injury to the spleen, and even a small hematoma may cause rupture of the splenic parenchyma in late pregnancy. The expansion of the uterus increases the pressure in the abdominal cavity, and the spleen is further elevated and tightly held in place by the surrounding ligaments, in which case a slight increase in abdominal pressure may cause the spleen to bend or rupture even more. Extreme changes in the tension of the ligaments radiating from the spleen surface can also lead to splenic injury. This mechanism of injury can explain splenic injury during rapid deceleration of the body. Direct trauma, such as trauma to the left upper abdomen, is secondary to the causes of splenic trauma, as occurs when the spleen is easily traumatized at the moment of inspiration, when the spleen moves caudally and ventrally, out of the protection of the surrounding thorax and right in the direction of the force, and the left rib arch contracts to contaminate the spleen. Typically, this can only occur in children and young adults with elastic thoraxes, and is also frequently combined with rib fractures, and rib fragments can also directly impale the spleen. Compared to blunt abdominal injuries, penetrating injuries such as abdominal cuts, stab wounds, and gunshot wounds are much less likely to cause splenic trauma. All wounds below the sixth rib on the left side, including the entrance or exit of the bullet, should be considered for the possibility of splenic injury and injury to other intra-abdominal organs. Splenic trauma can occur even if the entrance and exit of a gunshot wound is far from the left upper abdomen. A decelerating bullet can often travel a long distance subcutaneously or subfascially as it enters the abdominal cavity, and a bullet with high kinetic energy often turns due to surrounding tissues (e.g., peritoneal tissue), and a completely unexpected process occurs that may injure the spleen or other organs. Most splenic lacerations are perpendicular to the splenic axis, along the margins between splenic segments, and are less likely to damage the large blood vessels near the splenic hilum; very few splenic segment vessels are injured, and such transverse lacerations generally have moderate bleeding and a short bleeding time. Longitudinal lacerations that cross the intersplenial segmental boundaries tend to occur with more severe bleeding, and 40% of splenic trauma is multiple splenic lacerations.