Symptoms of a ruptured spleen

Written by valerie dansereau
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A ruptured spleen is an emergency medical condition that occurs when the spleen is damaged, leaking blood into your abdomen. Without medical attention, a ruptured spleen can cause very serious bleeding that in some cases is fatal. A splenic rupture is usually, but not always, treated with surgery.

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The Facts

The spleen is a small organ on the left side of your body under your rib cage. It is about the size of your fist. It filters the blood by removing damaged platelets and blood cells. It also has a role in helping your body fight infections. The most common symptoms of a damaged spleen are abdominal pain and tenderness in the left upper abdomen. Pain is sometimes accompanied by low blood pressure, lightheadedness and confusion. If the leak of blood is slow, you may not experience symptoms right away. As the blood continues to leak, you may experience dizziness and disorientation, and you may eventually lose consciousness.

Causes

A ruptured spleen is usually caused by a blow to the abdomen. When the abdomen suffers a trauma, such as in a car accident, the spleen is the organ most likely to be damaged. Other causes of splenic rupture include bicycle accidents, domestic violence and certain sports that involve contact. Some illnesses can also cause a damaged spleen, such as mononucleosis, blood cancer or liver disease. These diseases may cause the spleen to become enlarged, leaving it more vulnerable to rupture if a blow to the abdomen occurs.

Considerations

The pain of a ruptured spleen is often severe. It is usually felt under the left rib cage but may also be felt in the left shoulder. When a ruptured spleen causes internal bleeding, your blood pressure will drop, leading to blurred vision and signs of shock, such as paleness and restlessness. An untreated ruptured spleen can be fatal.

Diagnosis

If a ruptured spleen is suspected, there may not be time to run tests. A physical exam is done, and the doctor may find that the abdominal area looks swollen and feel hard. A sample of fluid may be drawn from your abdomen to test for the presence of blood. A CAT scan can help determine the amount of bleeding from the spleen. But if you are exhibiting a severe drop in blood pressure, emergency surgery may be done without waiting for a CAT scan.

Treatment

When emergency surgery is done, the entire spleen is usually removed. If the spleen hasn't completely ruptured, but only has small tears, the surgeon may try to repair the tears. Small injuries to the spleen may be treated without surgery. If your spleen is being treated without surgery, you would remain hospitalised and receive treatments such as blood transfusions.

After a Splenectomy

If your spleen is removed, but you're more likely to catch serious infections. After a splenectomy, your doctor will probably recommend annual flu vaccines and a pneumonia vaccine. Some people, especially children, are prescribed preventive antibiotics on a long-term basis. If your spleen is removed, be sure to call your doctor whenever you have symptoms of an infection.

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