The spleen is a small organ located at the upper left side of the abdomen and positioned behind the ribs that play a crucial role in regulating red and white blood cells along with platelets. However, in some cases, this organ can become enlarged or injured, resulting in a potentially life-threatening condition known as a ruptured spleen.
In this post, know how to save your or someone else’s life by recognizing the symptoms, causes, and treatment options for this medical condition.
What is a ruptured spleen?
A ruptured spleen (also known as a splenic rupture) is an emergency medical condition that demands immediate medical care, regardless of the severity of the symptoms. This occurs when a thin capsule of muscular tissue covering the spleen bursts or splits open, thus resulting in internal bleeding that could risk one’s life.
Causes of Ruptured Spleen
A ruptured spleen can be caused by a variety of factors, including:
Blunt force trauma
Physical trauma is considered to be the most common cause of a ruptured spleen. This fragile organ can easily rupture when subjected to direct blows, causing severe pain and potentially life-threatening complications.
Some examples of blunt-force trauma to the spleen include:
- vehicular accidents (e.g., motorcycle, bicycle)
- contact sports injuries (e.g., football, soccer)
- physical assault
Diseases or illnesses
In addition to physical trauma, a spleen may rupture spontaneously without any apparent injury or trauma. This is referred to as a non-traumatic rupture and is often associated with underlying medical conditions that gradually weaken the outer capsule of the organ.
Examples of such conditions include:
- infections (e.g., mononucleosis, malaria)
- cancer (e.g., lymphoma)
- liver disease
- metabolic diseases
Symptoms of Spleen Injury
Symptoms of spleen injury can vary in severity depending on the extent of damage to the organ. The most commonly reported symptom is abdominal pain, typically localized to the left side of the abdomen and left shoulder. The intensity of pain can range from mild to severe and may worsen with deep breathing or movement.
Other signs and symptoms to look out for include:
- tenderness: the area around the spleen, typically the upper left abdomen, may feel tender to the touch
- nausea and vomiting: a splenic rupture may cause nausea and vomiting, especially if the injury is severe
- low blood pressure: a ruptured spleen can cause a drop in blood pressure due to losing blood, which can lead to dizziness, confusion, fainting, and even shock
- rapid heartbeat: a rapid heartbeat may occur as the body tries to compensate for the reduced blood flow
- paleness: the skin may become pale due to reduced blood flow
- fatigue: spleen injury may also cause fatigue, weakness, and lethargy for some patients
Splenic Rupture Injury Scale
As mentioned earlier, a splenic injury may vary in severity depending on how badly the organ was ruptured. According to The American Association for the Surgery of Trauma (AAST), the stages of a ruptured spleen are as follows:
Grade 1
In the initial stage of a spleen injury, the capsule may incur a tear less than 1 cm deep in the spleen, or a hematoma may form under the capsule. The hematoma would only occupy less than 10 percent of the spleen’s surface area.
Grade 2
At this stage of spleen rupture, a 1 to 3-cm tear may occur, which does not affect the arterial branches of the spleen. Another possibility is the formation of a hematoma under the capsule, which can cover up to 50 percent of the surface area.
Additionally, a hematoma less than 5 cm in diameter may develop within the organ’s tissue.
Grade 3
A grade 3 spleen rupture is a severe tear that exceeds 3 cm in depth and may affect the splenic artery or result in a hematoma that covers more than half of the organ’s surface area.
This mid-stage rupture may also involve a hematoma larger than 5 cm or expanding within the organ tissue.
Grade 4
A grade 4 tear in the spleen can result in laceration of the segmental or hilar blood vessels, leading to a significant loss of over 25% of the organ’s blood supply.
Grade 5
This last stage is classified as a critical injury that damages crucial blood vessels, resulting in a complete loss of blood flow to the affected organ. This stage may also indicate that a hematoma has severely ruptured the spleen.
Knowing which scale a ruptured spleen is critical for doctors to determine the appropriate course of treatment, whether through surgical or non-operative management.
Treating Spleen Injury
The treatment for spleen injury depends on the severity of the injury. Sometimes, the injury may be minor and require only rest and pain medication. However, in more severe cases, surgery may be necessary.
Non-Surgical Treatment
In cases of minor spleen rupture, non-surgical treatment options are available. Treatment may involve pain management, rest, close monitoring, and blood transfusion if necessary.
Your doctor may also recommend avoiding strenuous activity until the injury has healed.
Surgical Treatment
Surgical intervention may be required for a severe or life-threatening spleen injury. Complete removal of the spleen, known as splenectomy, may be necessary.
Still, in most cases, the surgeon will opt for a partial splenectomy to preserve as much of the organ as possible.
Conclusion
A ruptured spleen is a serious condition that requires immediate medical attention. If you notice any signs of this condition, do not hesitate to seek medical help immediately. Timely treatment and appropriate care can lead to complete recovery, preventing the need for complete spleen removal.