How to tell if i have a ruptured spleen?

You cannot: The patient would have serious abdominal pain, shock, even death. Usually after major athletic or vehicular trauma. Occasionally with other disease with enlarged spleen a rupture can occur.

Usually : Ruptured spleen causes intra abdominal hemorrhage and shock within a few hours of injury. In some cases, a small tear can cause limited bleeding, which can even stop. The only way to know for sure whether you have a splenic injury or not, or its extent, is to do an imaging study, such as ultrasound or ct scan.