Abstract
Accessory spleen rupture can induce acute abdominal bleeding following minimal trauma or by atraumatic mechanisms. Spleen rupture is more frequent in pediatric patients and those affected by hematological diseases. We described the case of a 59-year-old male patient affected by hereditary spherocytosis referred to the emergency department for abdominal left side pain. An early ultrasound performed in the emergency department allowed to diagnosed hemoperitoneum by spontaneous bleeding of hypertrophic accessory spleen. Although abdomen computed tomography is the diagnostic method of choice, ultrasound can early detect sign of emoperitoneum in the emergency setting in case of hemodinamically unstable patient.