Is it possible to live with a ruptured spleen without getting surgery?

Yes. It depends mainly on the degree of injury. Some minor spleen injuries or fractures do heal without surgery, especially in children. Deeper or more extensive spleen injures may not heal without surgery though. Also if excess bleeding occurs requiring too many blood transfusions, then surgery may also be necessary.
Yes! Most people who have a spleen injury and come to the hospital with normal vital signs do not need surgery. After a few days of observation to see if any bleeding is current, most people are discharged home. The spleen completely heals in about six weeks, and most people can return to normal activity without having to worry about it.