A ruptured spleen is a serious injury that happens when the outer capsule of the spleen breaks open. This can cause pain in the upper left side of the abdomen, low blood pressure, dizziness, confusion, or fainting.
This condition is most often caused by trauma to the abdomen. It is more common in people who play contact sports or who have been in car accidents, for example.
A ruptured spleen is considered a medical emergency. Treatment should begin as soon as possible and will depend on the severity of the injury. It may involve a blood transfusion or emergency surgery to repair or remove the spleen.
Main symptoms
The main symptoms of a ruptured spleen include:
- Pain in the upper left side of the abdomen that may spread to the shoulder
- Tenderness when touching the abdomen
- Blurred vision
- Dizziness, lightheadedness, or confusion
- Nausea
- Restlessness or anxiety
- Fainting
Other possible signs include rapid heartbeat, low blood pressure, and pale skin. These may be caused by heavy internal bleeding, which can lead to hypovolemic shock.
If a ruptured spleen is suspected, it is important to go to the nearest hospital or emergency room as soon as possible so that the condition can be identified and treated appropriately.
Confirming a diagnosis
A ruptured spleen is diagnosed by a general practitioner or emergency doctor at the hospital. Diagnosis involves a review of symptoms, accident history, and a physical exam.
If the person shows signs of hypovolemic shock, the doctor may quickly perform a bedside abdominal ultrasound to confirm the diagnosis and move forward with emergency surgery.
For people with stable vital signs, a CT scan may be recommended. This type of imaging provides detailed information about the extent of the spleen injury and helps assess other abdominal organs.
Possible causes
The most common causes of a ruptured spleen include:
- Direct trauma to the left side of the abdomen
- Car or bicycle accidents
- Sports injuries
- Blunt force, stab wounds, or gunshot injuries to the spleen area
- Bariatric surgery
These situations can cause the spleen to rupture, leading to internal bleeding and the appearance of symptoms.
Although less common, there is also a higher risk of spontaneous (non-traumatic) spleen rupture in people with splenomegaly, which can happen due to infectious mononucleosis, malaria, lymphoma, hepatitis, or pancreatitis.
Treatment options
Treatment for a ruptured spleen is done at the hospital by a general practitioner, emergency doctor, or general surgeon. In most cases, emergency surgery called a splenectomy is needed to completely remove the spleen.
Blood transfusions may also be recommended, especially if the person has lost a large amount of blood.
In less severe cases, where the spleen injury is small and not life-threatening, the doctor may suggest a blood transfusion and removal of only the damaged part of the spleen.
This is because removing the spleen completely can make a person more vulnerable to infections. The spleen plays an important role in producing immune cells that help protect the body from illness.