After traumatic splenic rupture, 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 may also be found, but because of the presence of clots around the spleen, the right lumbar region may be hollow when the patient is lying on the left side, while 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. Differential diagnosis of a hollow sound in the right lumbar region when lying on the left side and a turbid sound in the left lumbar region when lying on the right side: 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 mostly caused by knife 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, car accidents, etc. It is the most common type of abdominal injury in clinical practice. Traumatic splenic rupture should be distinguished from rupture of liver, kidney, pancreas, mesenteric vessels, left rib fracture and ectopic pregnancy, as well as from certain medical diseases, such as acute gastroenteritis and even myocardial infarction. Signs and symptoms of splenic rupture vary with the amount and speed of bleeding, the nature and extent of rupture, and the presence of combined or multiple injuries to other organs. In patients with only subperitoneal rupture or central rupture, the main manifestation is left upper abdominal pain, which may increase when breathing, while the spleen is mostly enlarged and has pressure pain, abdominal muscle tension is usually not obvious, there is no nausea or vomiting, and other manifestations of internal bleeding are mostly absent. If incomplete rupture turns into complete rupture, acute symptoms will appear rapidly and the condition will deteriorate rapidly. Once complete rupture occurs, the first symptom will be peritoneal irritation. If the bleeding is slow and the amount is not too much, the abdominal pain may be limited to the left quadrant, but if the bleeding spreads to the whole abdomen, it may cause diffuse abdominal pain, but the left quadrant is still the most significant. Reflex vomiting is common, especially in the early stage of the disease. Sometimes blood irritation of the left diaphragm can cause referred pain in the left shoulder (distribution area of the 4th cervical nerve), often aggravated by deep breathing, called Kehr’s sign. Patients can then develop obvious symptoms of internal bleeding within a short period of time, such as thirst, panic, palpitations, tinnitus, weakness of limbs, shortness of breath, drop in blood pressure, and confusion; in severe cases, death can occur within a short period of time due to excessive bleeding and circulatory collapse. Physical examination may reveal generalized pressure pain and muscle tonicity in the abdominal wall, with the left upper abdomen being the most significant. The splenic turbid zone in the left quadrant is also often enlarged. If there is a large amount of blood accumulation in the abdomen, a mobile turbid sound 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 has a fixed turbid sound when the patient is lying on the right side, which is called the Ballance sign.