Which assessment finding is most common in a patient with a ruptured spleen?

In the context of a ruptured spleen, the most common assessment finding is left shoulder pain, also known as Kehr’s sign. This phenomenon occurs due to diaphragmatic irritation from blood accumulating in the abdominal cavity, which can irritate the phrenic nerve that supplies the diaphragm. The phrenic nerve also shares pathways with nerves that innervate the shoulder region, leading to referred pain in the left shoulder. Recognizing this sign is crucial because it can guide clinicians to suspect splenic injury, particularly in trauma patients.

Mid-abdominal pain and right upper quadrant pain can occur but are not specific to spleen injuries. Lower back pain can be an associated finding but is less common and not typically indicative of ruptured spleen. Understanding these relationships is essential for accurate assessment and timely intervention in these patients.