Description

A ruptured spleen is a medical emergency that occurs as a result of a break in your spleen's surface. Your spleen, situated just under your rib cage on the left side, helps your body fight infection and filter old blood cells from your blood.

A strong blow in the stomach during a sporting accident, a fight or a car accident, for example — is the most common cause of a ruptured spleen. If you have an enlarged spleen, a less forceful trauma can cause rupture. Without emergency treatment, the internal bleeding caused by the rupture of the spleen can be deadly.

Some people with rupture of spleen needs an emergency surgery. Others can be treated with several days of care in a hospital.

Symptoms

The signs and symptoms of a ruptured spleen are:

  • Pain in the upper left part of the stomach.
  • Tenderness when you touch the top left of the stomach.
  • Pain in the left shoulder.
  • Confusion, dizziness, or lightheadedness.

When to see a doctor

A ruptured spleen is a medical emergency. Seek emergency care after an injury, if the signs and symptoms indicate that there may be a rupture of the spleen.

Causes

The spleen may break due to:

  • Injury on the left side of the body. A rupture of the spleen is usually caused by a blow to the upper-left part of the abdomen or in the lower left part of the chest, such as might occur during sports, accidents, fights and car accidents. An injured spleen may rupture soon after the stomach of a trauma or, in some cases, days or weeks after the injury.
  • An enlargement of the spleen. The spleen can become enlarged when the blood cells accumulate in the spleen. An enlarged spleen can be caused by several underlying problems, such as infectious mononucleosis and other infections, diseases of the liver and cancer of the blood.

Risk factors

If the spleen is already enlarged due to an infection or other cause, there is a greater risk that the spleen might rupture. Contact sports that involve blows to the chest may also increase the risk of a rupture of the spleen.

Complications

A ruptured spleen can cause life-threatening bleeding in your stomach cavity.

Prevention

If you have been diagnosed with an enlarged spleen, ask your health care provider if you need to avoid activities over several weeks, which could cause the rupture. These may include contact sports, lifting heavy objects, and other activities that increase the risk of stomach trauma.

Diagnosis

Tests and procedures used to diagnose a rupture of the spleen are:

  • Physical exam. Your health care provider will press on your abdomen to determine the size of the spleen and if it's tender.
  • Blood tests. Blood tests to evaluate factors such as the platelet count and how well your blood clots.
  • The checking of blood in the abdominal cavity. In emergency situations, your health care team may use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals the blood in your stomach, you may be referred for emergency surgery.
  • Imaging tests of your stomach. If the diagnosis is not clear, your doctor may recommend a ct scan of the stomach, possibly with contrast, or another imaging test to look for other possible causes of your symptoms.

Treatment

The treatment for a ruptured spleen will depend on the severity of your condition. Serious injuries often require immediate surgery.

Many of small or moderate size of the lesions of the spleen can heal without surgery. It is likely that the stay in the hospital, while your health care team to observe your condition and provide non-surgical care, such as blood transfusions, if necessary.

You could have regular follow-up CT scan to check if the spleen has been cured or to determine if you need surgery.

Surgery and other procedures

Surgery for a ruptured spleen can include:

  • Repair the spleen. Your surgeon may be able to use the points of suture or other techniques for the repair of the rupture.
  • The removal of the spleen, called a splenectomy. People can live without a spleen, but increases the risk of serious bacterial infections such as sepsis. Your health care provider may recommend vaccination against meningitis, pneumonia and haemophilus influenza type b (Hib). Occasionally, you may be prescribed a daily oral antibiotics to prevent infections.
  • The removal of part of the spleen. It may be possible to delete only a part of his spleen, depending on the rupture. Partial splenectomy reduces the risk of infection that results from the removal of the whole spleen.

Spleen surgery is generally safe, but any surgery has risks, such as bleeding, blood clots, infection, and pneumonia.

Symptoms and treatment of Rupture of the spleen