This tends to occur when there is localized trauma to the left upper quadrant. It may be associated with left lower rib fractures. Because the spleen has such an extremely thin capsule, it is susceptible to injury even when there is no damage to surrounding structures, and because the spleen is highly vascular, when ruptured, it bleeds profusely into the peritoneal cavity. Splenic rupture should always be suspected with blunt abdominal injury. Current treatments preserve as much of the spleen as possible, but some patients require splenectomy.