Ruptured Spleen

What Is A Ruptured Spleen? What Causes A Ruptured Spleen?

Rupture of the capsule of the spleen is a potential catastrophe that requires immediate medical and surgical attention. Splenic rupture permits large amounts of blood to leak into the abdominal cavity, which is severely painful and life- threatening. Shock, and ultimately death, can result. Patients typically require immediate surgery.

The spleen is a fist-sized organ in the left upper quadrant of the abdomen that filters the blood by removing old or damaged blood cells and platelets using special white blood cells and helps the immune system by destroying bacteria and other foreign substances by opsonization and phagocytosis, and producing antibodies. It also stores approximately 33 percent of all platelets in the body.

A layer of tissue entirely covers the spleen in a capsule-like fashion, except where veins and arteries enter the organ. This tissue, called the splenic capsule, helps protect the spleen from direct injury.

In short, the spleen performs several functions including immune systems, filter functions, pitting, reservoir function and cytopoiesis.

It's important for a surgeon to be aware of the various functions of the spleen and the probable effects of splenectomy. Thus, a surgeon should try to preserve the spleen to maintain these functions.

What are the symptoms of a Ruptured Spleen?

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

If one notices any pain in the abdomen, specifically the upper left quadrant, this may be a symptom of a rupture. To determine what a ruptured spleen feels like, one has to have experienced some sort of a physical blow to the torso. The spleen won't just injure itself.

If you touch your stomach, the area will be tender to the touch as well as painful inside.

One must watch their vision. If you begin to feel light headed or even have blurry vision, it is a classic sign of what a ruptured spleen feel like. This means you could be losing a lot of blood inside your body.

Pay attention to mental awareness. Have someone you know to talk to you and make sure they believe you are not confused. When one loses enough blood, you will feel disoriented and confused.

What are the causes of a Ruptured Spleen?

Certain diseases and illnesses can also lead to a ruptured spleen. In such cases, the spleen becomes swollen and the capsule-like covering becomes thin. This makes the organ especially fragile and more likely to rupture if the abdomen receives a direct hit (such as forceful football tackle).

Blood cancers, infection and metabolic disorders are some of the things that can cause an enlarged spleen. Spleen enlargement can also be caused by liver diseases, such as cirrhosis and cystic fibrosis.
Rupture of a normal spleen can be caused by trauma, for example, in an accident. If an individual's spleen is enlarged, as is frequent in mononucleosis, most physicians will not allow activities (such as contact sports) where injury to the abdomen could be catastrophic.

Recent studies have also linked colonoscopy, a procedure that looks at the large intestine, to an increased risk of a ruptured spleen.

Diagnosing a Ruptured Spleen

A physical exam may be the only test done to diagnose a ruptured spleen. The doctor will feel the person's belly area and the abdominal area may feel hard and look swollen because it has filled with blood.

If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed.

Imaging tests can help diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on an abdominal CT scan without contrast.

However, a CT scan of the abdomen may only be done if time allows. A CT scan with contrast may take a while, and some people with spleen ruptures have died while waiting to have the test done. For this reason, a CT scan is not recommended for those with a spleen rupture who have unstable vital signs or low blood pressure due to the injury which suggests shock.

Diagnostic peritoneal lavage is a method to rapidly determine if blood is gathering in the abdominal area. It is fast and inexpensive, and can be done on spleen rupture patients who have low blood pressure.

An MRI of the abdomen may be an option for patients with kidney failure or who have severe allergies to the contrast substance used during a CT scan.

If the person is stable and does not need emergency surgery, laboratory tests such as a complete blood count (CBC) or hemoglobin level may be done at routine intervals to check for blood loss.

What are the treatment options for a Ruptured Spleen?

Doctors used to always remove a damaged spleen. However, removing the spleen can cause later problems, including an increased susceptibility to infections.

Doctors now realize that most small and many moderate-sized injuries to the spleen can heal without surgery, although blood transfusions are sometimes required and people must be treated in the hospital. When surgery is necessary, usually the entire spleen is removed (splenectomy), but sometimes surgeons are able to repair a small tear.

An alternative to open surgery for less urgent cases would be the removal of the spleen using a laparoscope. A thin tube with a camera is inserted through a small incision. Other tools are then inserted through other small incisions to remove the spleen.

Treatment for a ruptured spleen will depend on the severity of a patient's condition. If the doctor suspects that it is not an emergency situation, he may ask a patient to undergo blood and imaging tests first to clearly determine if the spleen has indeed ruptured. If the rupture is not big, a surgeon may be able to fix it without removing the entire organ.

Preventing a Ruptured Spleen

A ruptured spleen can be prevented by driving safely or by wearing protective gear while participating in sports. Avoid extreme or violent impacts in everyday life.

Some of the medical causes of an enlarged spleen may be preventable, such as cessation of alcohol abuse to prevent liver cirrhosis, or prophylaxis against malaria when planning a trip to an endemic area.



1 comment:

  1. A ruptured spleen hurts like hell. I ruptured mine playing football 6 weeks ago. My biggest concern is reutrning to football in the future. I underwent emergency surgery and am now trying to research what kind of risks there are to returning to contact sports. Anyone with experience who can help me out?


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