• Splenic Rupture

    Definition

    The spleen is an organ that helps filter the blood and produces white blood cells that make proteins that fight infection. A splenic rupture is a tear or split in the spleen and can lead to dangerous internal bleeding.
    Spleen
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    Causes

    Trauma to the area is a common cause of a splenic rupture. The spleen tissue may also be damaged if there is abnormal tissue growth or infection.

    Risk Factors

    Factors that may increase your risk of splenic rupture include:
    • Being in a motor vehicle accident
    • Playing contact sports
    • Inflammatory conditions, such as pancreatitis
    • Certain therapies and medications, such as blood thinning medications

    Symptoms

    Symptoms of splenic rupture may include:
    • Left shoulder pain
    • Abdominal pain
    • Abdominal swelling

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Images may need to be taken of your spleen. This can be done with:

    Treatment

    Talk with your doctor about the best treatment plan for you. This will be based on the size, extent, and severity of the laceration and the presence of other injuries. The goal when possible is to maintain all or part of the spleen. Options include:

    Close Monitoring

    Some spleen injuries may heal on their own with rest. Close monitoring in the hospital will most likely be needed. Blood transfusions may also be needed to replace lost blood and provide support during recovery.
    Some spleen injuries may heal on their own with rest. Close monitoring in the hospital will most likely be needed. Blood transfusions may also be needed to replace lost blood and provide support during recovery.

    Procedures

    Surgery may be needed if the spleen is severely damaged. When possible the spleen will be repaired. Otherwise, a part or all of the spleen may need to be removed (splenectomy). As much of the tissue will be spared as possible because the spleen helps protect the body against bacterial infections. If possible, splenectomy should be avoided in children and the elderly, since they have weaker immune systems.
    Surgery may be needed if the spleen is severely damaged. When possible the spleen will be repaired. Otherwise, a part or all of the spleen may need to be removed (splenectomy). As much of the tissue will be spared as possible because the spleen helps protect the body against bacterial infections. If possible, splenectomy should be avoided in children and the elderly, since they have weaker immune systems.

    Prevention

    Prevention will depend on the cause, but may include:
    • Wearing appropriate safety equipment when playing contact sports
    • Wearing a seatbelt when in a motor vehicle to help prevent accident-related chest or abdominal trauma

    RESOURCES

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    Trauma.org http://www.trauma.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Trauma Association of Canada http://www.traumacanada.org

    References

    Splenic injury. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries-poisoning/abdominal-trauma/splenic-injury. Updated December 2013. Accessed June 13, 2016.

    Splenic injury. University of Connecticut website. Available at: http://ksi.uconn.edu/emergency-conditions/internal-trauma/splenic-injury. Accessed June 13, 2016.

    Splenic injury and rupture. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116823/Splenic-injury-and-rupture. Updated December 21, 2015. Accessed June 13, 2016.

    Splenic trauma. Radiopaedia.org website. Available at: http://radiopaedia.org/articles/splenic-trauma. Accessed June 13, 2016.

    Revision Information

    • Reviewer: James Cornell, MD
    • Review Date: 09/2016
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