What is a ruptured spleen?
A ruptured spleen occurs when the surface of this organ is injured, which can lead to internal bleeding. A ruptured spleen can potentially be life-threatening if it is not treated quickly.
The spleen is an organ about the size of a fist, located in the left upper abdomen, near the stomach. The spleen is part of the lymphatic system, which helps fight infection and also filters the blood.
Symptoms and Causes
What causes a ruptured spleen?
The surface of the spleen is protected by a layer of tissue called the capsule. An injury to this layer is usually associated with blunt trauma, but can also occur with conditions that cause splenomegaly (an enlarged spleen).
Injuries to the spleen can be caused by:
- Car, motorcycle or bicycle accidents
- Contact sports such as football
Diseases that can increase the risk of splenic rupture include:
- Infections such as mononucleosis or malaria
- Cancers, such as lymphoma, that lead to an enlarged spleen
- Metabolic disorders
- Liver disease
What are the symptoms of a ruptured spleen?
The main symptom of a ruptured spleen is severe pain in the abdomen, especially on the left side. The pain may also be referred to (felt in) the left shoulder, and can make breathing painful.
Other symptoms, which are associated with a decrease in blood pressure due to internal bleeding, include:
- Feeling lightheaded
- Blurred vision
Diagnosis and Tests
How is a ruptured spleen diagnosed?
A ruptured spleen is usually diagnosed based on the patient’s history and a physical examination. Often, if the patient is stable, an ultrasound or CT scan will be performed.
Management and Treatment
How is a ruptured spleen treated?
Treatment of this condition depends on the severity of the injury. In the most extreme cases, in which a large amount of blood has been lost and the patient is critically ill, emergency surgery to remove the spleen (splenectomy) is necessary.
If the injury to the spleen is not severe, then less invasive measures can be taken. This approach involves admitting the patient to the hospital and closely observing him or her. Vital signs and blood counts are also closely monitored, and a CT scan may be performed for further evaluation. Most of these patients will not need to have their spleen removed.
Can a ruptured spleen be prevented?
Obviously, a ruptured spleen caused by a traumatic injury cannot be prevented. However, if you have a condition that may cause your spleen to swell – including mononucleosis – then you should avoid activities that could increase your risk of an injury to the spleen, such as contact sports.
Outlook / Prognosis
What is the prognosis (outlook) for someone who has undergone an emergency splenectomy?
Once the spleen is removed, or has healed, most people can live a normal life. After removal, other organs, including the liver, will take over the functions of the spleen. However, patients who have undergone a splenectomy are at an increased risk of developing infections and must take precautions, such as staying up to date on the recommended immunizations, including a yearly flu shot.
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