Sudden splenic pain is commonly associated with traumatic splenic rupture and, rarely, splenic abscess. The most common cause of splenic pain is splenic rupture following a closed abdominal injury, which includes true rupture and pseudorupture. A true rupture is an interruption of the splenic envelope and is characterized by intra-abdominal hemorrhage and usually requires emergency splenectomy to cure. Pseudorupture is usually a subperitoneal hematoma without free abdominal bleeding and can be treated conservatively, but most patients may have a true rupture due to an enlarged pseudoruptured subperitoneal hematoma one to two weeks after the trauma, leading to the possibility of a repeat splenectomy. The exact cause of splenic abscess is not known; the main cause is the formation of bacterial infection into the spleen, which usually requires splenectomy.