Ruptured spleen

A ruptured spleen is considered as a medical emergency that involves tearing of outer lining of your spleen. The largest organ in our lymphatic system is the spleen. It is positioned below the rib cage above the stomach in the upper left quadrant of the abdomen. Our red blood cells are stored and purified in the spleen.

The spleen is a very delicate organ, and it is protected by a capsule-like layer called splenic capsule. When the splenic capsule breaks open, the spleen may be ruptured. Based on the extent of rupture, the amount of internal bleeding may occur.

Symptoms

The most common signs and symptoms of a ruptured spleen include:

  • Pain in the upper left quadrant of abdomen
  • Tenderness near the abdomen
  • Lightheadedness or dizziness
  • Disorientation or confusion

As ruptured spleen is a medical emergency, you must seek medical attention immediately if you have any of the above listed signs of symptoms.

Causes

When the abdomen suffers a direct blow or blunt trauma, your spleen may be ruptured. Motor vehicle accidents, sports injuries, bicycle accidents and domestic violence may cause a rupture in the spleen.

Certain illnesses such as malaria, hemolytic anemia, lymphoma and infectious mononucleosis cause your spleen and to swell and makes the capsule-like covering weak and thin; this leads to splenic rupture.

It is also known that colonoscopy, a procedure used for looking at the large intestine, may also increase the risk of splenic rupture.

The tests and procedures that are used for diagnosing ruptured spleen include:

Physical examination: Your doctor performs a physical examination to determine the size of your spleen and checks if you feel abdominal tenderness.
Blood tests : Your doctor would order for the routine blood tests to evaluate the platelet count and the overall blood cells, and to check the presence of any infection, which is determined by the increase in WBC or ESR rate.
Ultrasound testing : Your doctor may use ultrasound testing to check for the blood in your abdominal cavity due to splenic rupture that may require an emergency treatment.
Imaging tests of your abdomen : Your doctor may recommend for computerized tomography (CT) scan or other imaging tests to rule out other possible causes of the presented symptoms.

The treatment options for ruptured spleen are based on the severity of your condition and include the following:

Hospitalization

Small to moderate forms of spleen ruptures can heal without surgery. Your doctor would provide nonsurgical care, such as blood transfusions, etc. if necessary.

Your doctor may follow-up CT scans to check the condition of the spleen that if it has healed or does it requires surgery.

Surgery

Surgical procedures for ruptured spleen include:

Repair: surgeon would stitch up the ruptured spleen
Splenectomy: The injured spleen is removed in this procedure. But the drawback of this procedure is the chances of infection or sepsis.
Partial splenectomy: Your doctor removes only the portion of the spleen that is damaged. This procedure has fewer chances of acquiring infection post surgically.

These procedures are performed laparoscopically (through small incisions), a special camera and surgical tools are used. Spleen surgery is considered as the safest surgery, although all the surgical techniques would have the risk of bleeding, blood clots, infection, and pneumonia.