Table of ContentsView AllTable of ContentsOverviewSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Overview
Symptoms
Causes
Diagnosis
Treatment
A ruptured spleen refers tobleeding into the abdominal cavityfrom a torn or lacerated spleen. Most spleen damage is due to traumatic injury, but it can occur spontaneously if the spleen is inflamed or diseased.
All of the circulation of blood and lymph through the spleen makes it a prime candidate for bleeding if injured. When traumatic injuries affect multiple body systems, 10% to 12% involve abdominal trauma.The liver and spleen are the two most commonly injured abdominal organs. Considering trauma is the fourth leading cause of death, that indicates a lot of ruptured spleens and livers.
This article discusses the symptoms, causes, diagnosis, and treatment of a ruptured spleen.
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The spleen is a small organ located in the upper left quadrant of the abdomen under the ribcage (well above and far left of the belly button). If you could see the spleen, it looks purple and squishy. It’s considered a solid organ, meaning it’s not hollow like a bladder or a stomach. Its consistency is more like a small version of the liver. The fullfunction of the spleenis still under debate, but we do know it plays a major role in the immune system.
Half of the spleen tissue is called the red pulp and is responsible for filtering out old and damaged red blood cells, and acts as a reservoir for platelets and red blood cells. The other tissue is the white pulp, which produces antibodies and is connected to the lymphatic system.
What Happens if Your Spleen Ruptures?
In trauma with an injury to the abdomen, the most common symptoms of a ruptured spleen are pain and tenderness of the abdomen, particularly on the left upper quadrant. As blood enters the abdominal cavity, it can lead to a symptom known as referred pain. This is pain that you feel somewhere other than where the injury is located.
In the case of a ruptured spleen, the most common referred pain is felt in the left shoulder or left side of the chest wall.
Since the spleen is so rich with blood flow, bleeding from a rupture can be significant. If left untreated, bleeding from a ruptured spleen can very quickly lead to hypovolemia (when the plasma portion of the blood is too low) andshock(a medical condition that decreases blood flow to the brain).
As the circulatory system struggles to get blood to important areas such as the brain, symptoms may include sweating, lightheadedness, fatigue, confusion, and eventually unconsciousness.
What is the survival rate for a ruptured spleen?The survival rate for a severely ruptured spleen (grades IV and V) is estimated to be about 90% with both splenectomy and non-operative management.Survival rates for mild and moderate spleen rupture are likely to be even higher as long as it’s diagnosed early.
What is the survival rate for a ruptured spleen?
The survival rate for a severely ruptured spleen (grades IV and V) is estimated to be about 90% with both splenectomy and non-operative management.Survival rates for mild and moderate spleen rupture are likely to be even higher as long as it’s diagnosed early.
What Causes a Ruptured Spleen?
The most common cause of a ruptured spleen is blunt trauma to the abdomen, such as that experienced in a car crash or a fall from a significant height.Blunt trauma is the type of trauma that does not directly penetrate the skin, like a stabbing or gunshot wound. Penetrating trauma is less common, but can also lead to a ruptured spleen.
In rare cases, a ruptured spleen can occur spontaneously without trauma. The spleen can become inflamed and enlarged from infection, cancer, orother diseases. The disease that is often associated with a non-traumatic ruptured spleen is mononucleosis, even though the incidence of a ruptured spleen occurs in an estimated 0.1% to 0.5% of all cases of mononucleosis.
Diagnosing a Ruptured Spleen
Diagnosing a ruptured spleen may include:
A CT scan is the best option for evaluating the abdomen and diagnosing a ruptured spleen.CT scans can detect as little as 100 cubic centimeters of blood in the abdomen, an amount similar to about one-third of a can of soda.
Ruptured Spleen Treatment
Non-surgical management of a ruptured spleen is the primary option for treatment as long as the patient’s blood pressure is stable and there is no severe bleeding. Close monitoring, bed rest, and blood pressure control are used to give the spleen time to heal. For patients who come to the hospital with stable blood pressure, non-surgical treatment is very successful.
Some hospitals may try interventional radiological treatment for ruptured spleens. This is a relatively recent option and is not always available.
Depending on the severity of the ruptured spleen and how stable the blood pressure is, the patient may have to have surgery.Blood transfusions may also be necessary to replace lost blood.
The surgeon will focus on repairing the spleen if possible, however part or all of the spleen may have to be removed (called asplenectomy). If the spleen is removed, aseries of vaccinationsmay be needed to boost immune function after surgery.
Summary
What Conditions Affect the Spleen?
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chiotoroiu AL, Venter DM, Negoi I, et al.Splenic implant assessment in trauma.Chirurgia (Bucur). 2014;109(6):731-40.The American Association for the Surgery of Trauma.Trauma facts.Wu M, Kao W, Chan C, Yiang G, Liao W, Chen C.Spontaneous splenic rupture as a rare initial presentation in an acute lymphoblastic leukemia patient.Diagnostics. 2019;9(4):152. doi:10.3390/diagnostics9040152Medscape.Splenic rupture treatment & management.UpToDate.Management of splenic injury in the adult trauma patient.Sylvester JE, Buchanan BK, Paradise SL, et aI.Association of splenic rupture and infectious mononucleosis: a retrospective analysis and review of return-to-play recommendations.Sports Health. 2019 Nov/Dec;11(6):543-549. doi: 10.1177/1941738119873665Merck Manual Consumer Version.Spleen injury.Unal E, Onur MR, Akpinar E, et al.Imaging findings of splenic emergencies: a pictorial review.Insights Imaging. 2016;7(2):215-222. doi:10.1007/s13244-016-0467-8Zarzaur B, Rozycki G.An update on nonoperative management of the spleen in adults.Trauma Surg Acute Care Open. 2017;2(1):e000075. doi:10.1136/tsaco-2017-000075The American Association for the Surgery of Trauma.Blunt splenic trauma.Additional ReadingAkoury T, Whetstone DR.Splenic rupture. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Eko FE, Fouelifack FY, de Paul EV.Spontaneous rupture of the spleen operated in gynecological unit mistaken for ruptured hemorrhagic ovarian cyst: total splenectomy.Pan Afr Med J. 2014;19:324. doi:10.11604/pamj.2014.19.324.5749Patterson JW, Dominique E.Acute abdomen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Tunçyürek Ö, Tunçyürek P, Ertekin E, et al.Pathological rupture of the normal spleen: review with the literature.Int J Surg Case Rep. 2016;26:163-5.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Chiotoroiu AL, Venter DM, Negoi I, et al.Splenic implant assessment in trauma.Chirurgia (Bucur). 2014;109(6):731-40.The American Association for the Surgery of Trauma.Trauma facts.Wu M, Kao W, Chan C, Yiang G, Liao W, Chen C.Spontaneous splenic rupture as a rare initial presentation in an acute lymphoblastic leukemia patient.Diagnostics. 2019;9(4):152. doi:10.3390/diagnostics9040152Medscape.Splenic rupture treatment & management.UpToDate.Management of splenic injury in the adult trauma patient.Sylvester JE, Buchanan BK, Paradise SL, et aI.Association of splenic rupture and infectious mononucleosis: a retrospective analysis and review of return-to-play recommendations.Sports Health. 2019 Nov/Dec;11(6):543-549. doi: 10.1177/1941738119873665Merck Manual Consumer Version.Spleen injury.Unal E, Onur MR, Akpinar E, et al.Imaging findings of splenic emergencies: a pictorial review.Insights Imaging. 2016;7(2):215-222. doi:10.1007/s13244-016-0467-8Zarzaur B, Rozycki G.An update on nonoperative management of the spleen in adults.Trauma Surg Acute Care Open. 2017;2(1):e000075. doi:10.1136/tsaco-2017-000075The American Association for the Surgery of Trauma.Blunt splenic trauma.Additional ReadingAkoury T, Whetstone DR.Splenic rupture. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Eko FE, Fouelifack FY, de Paul EV.Spontaneous rupture of the spleen operated in gynecological unit mistaken for ruptured hemorrhagic ovarian cyst: total splenectomy.Pan Afr Med J. 2014;19:324. doi:10.11604/pamj.2014.19.324.5749Patterson JW, Dominique E.Acute abdomen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Tunçyürek Ö, Tunçyürek P, Ertekin E, et al.Pathological rupture of the normal spleen: review with the literature.Int J Surg Case Rep. 2016;26:163-5.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Chiotoroiu AL, Venter DM, Negoi I, et al.Splenic implant assessment in trauma.Chirurgia (Bucur). 2014;109(6):731-40.The American Association for the Surgery of Trauma.Trauma facts.Wu M, Kao W, Chan C, Yiang G, Liao W, Chen C.Spontaneous splenic rupture as a rare initial presentation in an acute lymphoblastic leukemia patient.Diagnostics. 2019;9(4):152. doi:10.3390/diagnostics9040152Medscape.Splenic rupture treatment & management.UpToDate.Management of splenic injury in the adult trauma patient.Sylvester JE, Buchanan BK, Paradise SL, et aI.Association of splenic rupture and infectious mononucleosis: a retrospective analysis and review of return-to-play recommendations.Sports Health. 2019 Nov/Dec;11(6):543-549. doi: 10.1177/1941738119873665Merck Manual Consumer Version.Spleen injury.Unal E, Onur MR, Akpinar E, et al.Imaging findings of splenic emergencies: a pictorial review.Insights Imaging. 2016;7(2):215-222. doi:10.1007/s13244-016-0467-8Zarzaur B, Rozycki G.An update on nonoperative management of the spleen in adults.Trauma Surg Acute Care Open. 2017;2(1):e000075. doi:10.1136/tsaco-2017-000075The American Association for the Surgery of Trauma.Blunt splenic trauma.
Chiotoroiu AL, Venter DM, Negoi I, et al.Splenic implant assessment in trauma.Chirurgia (Bucur). 2014;109(6):731-40.
The American Association for the Surgery of Trauma.Trauma facts.
Wu M, Kao W, Chan C, Yiang G, Liao W, Chen C.Spontaneous splenic rupture as a rare initial presentation in an acute lymphoblastic leukemia patient.Diagnostics. 2019;9(4):152. doi:10.3390/diagnostics9040152
Medscape.Splenic rupture treatment & management.
UpToDate.Management of splenic injury in the adult trauma patient.
Sylvester JE, Buchanan BK, Paradise SL, et aI.Association of splenic rupture and infectious mononucleosis: a retrospective analysis and review of return-to-play recommendations.Sports Health. 2019 Nov/Dec;11(6):543-549. doi: 10.1177/1941738119873665
Merck Manual Consumer Version.Spleen injury.
Unal E, Onur MR, Akpinar E, et al.Imaging findings of splenic emergencies: a pictorial review.Insights Imaging. 2016;7(2):215-222. doi:10.1007/s13244-016-0467-8
Zarzaur B, Rozycki G.An update on nonoperative management of the spleen in adults.Trauma Surg Acute Care Open. 2017;2(1):e000075. doi:10.1136/tsaco-2017-000075
The American Association for the Surgery of Trauma.Blunt splenic trauma.
Akoury T, Whetstone DR.Splenic rupture. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Eko FE, Fouelifack FY, de Paul EV.Spontaneous rupture of the spleen operated in gynecological unit mistaken for ruptured hemorrhagic ovarian cyst: total splenectomy.Pan Afr Med J. 2014;19:324. doi:10.11604/pamj.2014.19.324.5749Patterson JW, Dominique E.Acute abdomen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.Tunçyürek Ö, Tunçyürek P, Ertekin E, et al.Pathological rupture of the normal spleen: review with the literature.Int J Surg Case Rep. 2016;26:163-5.
Akoury T, Whetstone DR.Splenic rupture. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Eko FE, Fouelifack FY, de Paul EV.Spontaneous rupture of the spleen operated in gynecological unit mistaken for ruptured hemorrhagic ovarian cyst: total splenectomy.Pan Afr Med J. 2014;19:324. doi:10.11604/pamj.2014.19.324.5749
Patterson JW, Dominique E.Acute abdomen. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
Tunçyürek Ö, Tunçyürek P, Ertekin E, et al.Pathological rupture of the normal spleen: review with the literature.Int J Surg Case Rep. 2016;26:163-5.
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