What is a common symptom of a ruptured spleen?

A ruptured spleen commonly presents with left upper quadrant pain due to its anatomical location. The spleen is situated in the upper left part of the abdomen, and when it ruptures, the pain is typically felt in this area. Additionally, referred pain to the shoulder, known as Kehr's sign, occurs because of irritation of the diaphragm by blood or fluid in the abdominal cavity. This irritation can stimulate the phrenic nerve, which is also responsible for feeling pain in the shoulder area.

Pain in the right upper quadrant is not characteristic of a splenic rupture and is more closely associated with injuries or conditions affecting the liver or gallbladder. While abdominal swelling can occur in traumatic situations, it may not be a definitive symptom of a ruptured spleen specifically. Lower back pain is also not a typical symptom associated with splenic injuries; the pain tends to localize more to the abdomen or shoulder regions rather than the lower back. Therefore, the choice highlighting left upper quadrant pain and referred pain to the shoulder accurately reflects the common symptoms associated with a ruptured spleen.