A ruptured spleen is a serious medical event where the spleen’s surface breaks, leading to internal bleeding. This condition requires prompt medical attention due to the potential for significant blood loss. Situated beneath the rib cage on the left side of the upper abdomen, the spleen is an organ that plays a role in several bodily functions.
Understanding the Spleen’s Role
The spleen acts as a filter for the blood, removing old, malformed, or damaged red blood cells. It also stores red blood cells and platelets, which help blood clot.
Beyond filtering, the spleen is involved in the immune system, producing white blood cells and antibodies to fight infections.
Its highly vascular nature means it contains many blood vessels, making it susceptible to substantial bleeding if injured.
Recognizing the Signs of a Rupture
A ruptured spleen often presents with distinct symptoms, though their severity varies with the injury’s extent and internal bleeding.
Patients commonly experience severe pain or tenderness in the upper left abdomen. This pain may extend to the left shoulder (Kehr’s sign), caused by nerve irritation beneath the diaphragm.
Beyond localized pain, signs of internal bleeding can manifest throughout the body. These may include lightheadedness, dizziness, confusion, or blurred vision.
Signs of hypovolemic shock may also appear, such as a rapid heart rate, low blood pressure, and paleness. Symptoms can progress rapidly, even hours after an initial injury.
Common Causes of Spleen Rupture
The most frequent cause of a ruptured spleen is blunt abdominal trauma. This type of injury can result from various incidents, including motor vehicle collisions, sports accidents, or falls. Such impacts can directly injure the spleen, causing rupture.
While trauma is the predominant cause, a spleen can also rupture due to underlying medical conditions. An enlarged spleen, often caused by infections like mononucleosis or certain blood disorders, becomes more fragile and prone to rupture, even spontaneously.
Immediate Action and Seeking Medical Care
If a ruptured spleen is suspected, perhaps due to symptoms following an abdominal injury, seeking immediate emergency medical attention is necessary. Calling emergency services or going to the nearest emergency room without delay is the appropriate course of action.
Prompt medical care is important because internal bleeding from a ruptured spleen can quickly become life-threatening. The amount of blood loss can impact blood pressure and overall stability, necessitating urgent intervention. Even if symptoms appear minor initially, internal bleeding can worsen rapidly, making rapid assessment by medical professionals important.
Diagnosis and Treatment Approaches
Diagnosing a ruptured spleen typically begins with a physical examination, where medical staff assess abdominal tenderness and distension. Imaging tests are then used to confirm the diagnosis and determine the extent of the injury. An ultrasound (FAST exam) can quickly detect internal bleeding. A computed tomography (CT) scan, often with contrast, provides a detailed view of the spleen and surrounding structures, helping to grade the injury’s severity.
Treatment approaches vary based on the injury’s grade and the patient’s condition. For minor ruptures in stable individuals, non-operative management with close hospital monitoring may be sufficient, allowing the spleen to heal on its own. This may involve observation and potentially blood transfusions if there is significant blood loss.
More severe cases, or those with ongoing bleeding and instability, often require surgical intervention. This could involve repairing the spleen (splenorrhaphy), or in some instances, complete removal (splenectomy).