The spleen, a fist-sized organ located under the left rib cage, plays a significant role in the body’s immune system and blood filtration. It removes old or damaged red blood cells, stores blood, and produces white blood cells that fight infection. A ruptured spleen is a medical emergency that can lead to life-threatening internal bleeding, requiring immediate medical attention.
Causes of a Ruptured Spleen
A ruptured spleen most commonly results from significant physical trauma to the abdomen. Forceful blows to the left upper stomach or lower chest, often sustained during car accidents, sports injuries, or falls, are frequent causes. The spleen’s location and delicate structure make it particularly vulnerable to such blunt force impacts.
Less common causes include an enlarged spleen, a condition known as splenomegaly. When the spleen is enlarged due to certain illnesses, its capsule-like covering becomes thinner and more fragile. This increased fragility means even minor trauma or, in rare cases, no trauma at all, can lead to a rupture. Conditions such as infectious mononucleosis, malaria, liver disease, or certain blood cancers can cause the spleen to swell, increasing its risk of rupture.
Recognizing the Signs of a Ruptured Spleen
A person may experience pain in the upper left abdomen, which can intensify when touched. This pain can also radiate to the left shoulder, a phenomenon known as Kehr’s sign, due to irritation of the diaphragm.
Beyond localized pain, a ruptured spleen can cause symptoms related to internal blood loss. These may include dizziness, lightheadedness, confusion, and blurred vision. Signs of shock, such as a rapid heart rate, low blood pressure, pale skin, and restlessness, can also indicate significant internal bleeding. Symptoms can vary in severity and may not always be immediately apparent, sometimes developing hours or even days after the initial injury.
Why a Ruptured Spleen Poses a Risk to Life
A ruptured spleen presents a significant risk to life primarily because of its rich blood supply. The spleen is highly vascular, containing a large amount of blood at any given time. When its surface breaks, blood rapidly pours into the abdominal cavity, leading to severe internal bleeding, also known as hemorrhage.
This rapid and substantial blood loss can quickly lead to hypovolemic shock. This occurs when the body loses too much blood, causing a drastic drop in blood pressure and insufficient blood supply to vital organs. Without enough blood circulating, organs like the brain, heart, and kidneys do not receive adequate oxygen, which can lead to organ failure and, if untreated, death.
Emergency Response and Treatment
Upon arrival at a medical facility, healthcare professionals will perform a physical examination and may order imaging tests, such as a CT scan or ultrasound, to confirm the diagnosis and assess the extent of the bleeding. Stabilization of the patient is a priority, often involving intravenous fluids and blood transfusions to counter the effects of shock and replace lost blood.
Treatment depends on the rupture’s severity. For minor ruptures, non-surgical management involving close observation and bed rest in a hospital setting may be an option, allowing the spleen to heal on its own. For more severe ruptures with significant or ongoing bleeding, surgical intervention is typically required. This often involves a splenectomy, the complete removal of the spleen, to stop life-threatening hemorrhage.