A ruptured spleen is a medical emergency that happens after the spleen develops a break in its surface. Your spleen, located just under your rib cage on your left side, helps the body fight infection and filter old blood cells from the bloodstream. A ruptured spleen is usually caused by a forceful blow to your abdomen. Without immediate emergency treatment, a ruptured spleen can cause life-threatening internal bleeding. Some people with ruptured spleens need emergency surgery. Others can be treated with just several days of hospital care. Here is everything you need to know.
What Causes a Ruptured Spleen?
The spleen can rupture when the abdomen suffers a severe blow or blunt trauma. Actually, spleen is the most frequent organ to be damaged in blunt trauma injuries involving the abdomen. The following are among the frequent causes of spleen injuries:
- Motor vehicle accidents
- Injury during contact sports, such as football and hockey
- Bicycle accidents, such as falling into your bicycle's handlebars
- Domestic violence
Certain diseases and illnesses can also lead to a ruptured spleen. In such cases, the spleen becomes swollen and the capsule-like covering becomes thin. This makes the organ extremely fragile and more likely to rupture if the abdomen receives a direct strong hit.
Diseases that increase the risk for a ruptured spleen include:
- Infectious mononucleosis
- Blood diseases such as hemolytic anemia and certain types of lymphoma
The symptoms of a ruptured spleen are very often accompanied by other signs of injury caused by blunt trauma to the abdomen. Examples of these other injuries include rib fractures, pelvic fracture, and spinal cord injury. The location of the spleen means that injury can cause pain in the upper-left part of the abdomen. However, after a rupture, pain can occur in other locations as well, such as the left chest wall and shoulder.
Other symptoms include:
- blurred vision
- signs of shock, including restlessness, nausea, and paleness
How Is a Ruptured Spleen Treated?
In the past, treatment for a spleen injury always included removal of the entire organ, called a splenectomy. However, doctors now say that some spleen injuries can heal on their own, particularly those that are not very severe. People with spleen injuries who do not need surgery must still be monitored in a hospital, and they may need blood transfusions as well.
Immediate, emergency surgery to remove or repair the spleen is done in the following cases:
- If there is massive internal bleeding
- If a person with a suspected spleen rupture has low blood pressure or unstable vital signs
When surgery is done, the entire spleen is still removed in most cases. However, in the case of small tears, the surgeon may try to save the spleen instead. This involves repairing the tear and putting pressure on the spleen or blood vessels till the blood clots and stops the leak. Another procedure, called arterial embolization, may be a safe way to save the spleen, but only if it can be done right away.
Recovery depends on the severity of the rupture. Usually, the outcome is excellent for those with more mild spleen ruptures. The more serious the injury, the more guarded the outcome. The risk of complications appears to be greatest in people over age 55. Deaths caused by splenic rupture are possible and do still occur, even at the top trauma centers.