A ruptured spleen is a life threatening medical emergency. It requires immediate medical attention. While surgery is not always necessary, timely treatment is critical.
The spleen is a small organ in the upper left part of your abdomen. It plays an important role in fighting infection, supporting immunity, and cleaning the bloodstream of bacteria and old blood cells.
Occasionally, the spleen can be injured. It can even rupture or tear. In the United States, about 40,000 people experience a spleen injury each year.
Facts about the spleen:
- The spleen is located in the upper left portion of the abdomen, just behind the ribs and stomach.
- The spleen helps filter out cellular waste, including old blood cells.
- It also helps fight infections and provides immunity support.
- The spleen can become enlarged if a person is sick or injured.
- A ruptured spleen occurs when there’s a break or tear on the spleen’s surface.
A ruptured spleen is usually the result of one of two things:
- a forceful blow or traumatic injury to the abdomen, or
- an enlarged spleen that tears
Even a minor injury can cause small tears or bruising to the spleen. But a severe injury could result in a break on the spleen’s surface — a rupture.
An enlarged spleen can make a tear or break in the spleen’s surface more likely. An enlarged spleen is often due to an existing disease or condition.
If you have an enlarged spleen, even minor trauma or injury could lead to a rupture.
Can the spleen rupture on its own?
A ruptured spleen is rare, but a spontaneous spleen rupture is even rarer. A spontaneous rupture occurs without any physical trauma or injury.
In most cases, an enlarged spleen is responsible for a spontaneous rupture or tear. Infections and certain medical conditions, such as malaria and lymphoma, can cause blood cells to accumulate in the spleen. As this happens, the spleen grows larger, putting stress on the surface of the organ.
Rarely, this pressure may be too much, and the surface of the spleen can break.
A ruptured spleen is a medical emergency. You should seek immediate medical attention if you have symptoms of a ruptured spleen.
The spleen is a complex matrix of blood vessels and blood-filled compartments (splenic cords and venous sinuses). In the event of a tear or rupture, internal bleeding is possible. This can be life threatening.
Even if you don’t have signs or symptoms of internal bleeding, your condition could change quickly. You could go from being stable to gravely ill in a matter of 24 to 48 hours if a ruptured spleen is not properly treated.
Symptoms of a ruptured spleen include:
- pain in the upper left abdomen
- tenderness in the upper left abdomen, especially when pressed
- left shoulder pain, especially if you’ve experienced no obvious trauma (Kehr’s sign)
- lightheadedness or dizziness
The symptoms of a ruptured spleen may not be obvious until significant internal bleeding has already occurred.
That’s why it’s important to get immediate medical attention if you have any of these symptoms, especially after an injury or if you’ve been previously diagnosed with an enlarged spleen.
If your doctor suspects a ruptured spleen, they will likely order a CT scan or ultrasound to confirm the diagnosis.
A CT scan can show any injury or damage to the spleen. It can also detect internal bleeding and a possible hematoma, or collection of blood under the spleen’s surface.
An ultrasound may also be helpful in an emergency situation. CT scans require patients to be more stable, but an ultrasound can be used quickly to rule out other issues.
If neither of these tests is able to confirm a diagnosis, your doctor may order a laparotomy. This surgical procedure allows a surgeon to explore the abdominal cavity. Images from the test may help determine what’s causing specific symptoms.
Treatment for a ruptured spleen
Treatment for a ruptured spleen typically falls into two camps: several days of intensive hospital care or surgery.
If the injury or damage to the spleen is too great, or if doctors are unable to stop the internal bleeding, a splenectomy is often the treatment of choice. In 10% to 15% of patients with a blunt spleen injury, surgical spleen removal is necessary.
However, in some cases, a more conservative approach is taken. Several days of hospital care and regular testing will be necessary to make sure the injury to the spleen doesn’t worsen.
Recovering from a ruptured spleen is not fast. You’ll likely need several days of hospital care before you’ll be released. Then, you’ll have regular follow-ups to monitor for changes or signs of secondary tears.
One study found that most people with higher grade spleen injuries (including tears) were completely healed within 75 days of their injury.
However, a few factors can slow down this timeframe. Underlying health conditions can impair recovery, as can additional trauma or injury.
A ruptured spleen can also worsen in a matter of a few days or weeks after the initial injury and may rupture again. That can complicate and slow down recovery, too.
After a splenectomy, your doctor may recommend a series of vaccinations. Without a spleen, your body may not be able to fight off infection as well as it did before, so these vaccinations will be important for preventing serious illness.
These vaccinations include:
- influenza vaccine: helps protect against the seasonal flu
- Tdap vaccine: helps protect against tetanus, diphtheria, and whooping cough
- Hib vaccine: helps protect against bacterial meningitis
- zoster vaccine: helps protect against shingles
- meningococcal vaccine: helps protect against meningitis
A ruptured spleen can be a life threatening condition and requires immediate attention. Symptoms most often include pain or tenderness in the upper left abdomen, pain in the left shoulder, dizziness, and confusion.
In most cases, a ruptured spleen is caused by blunt force trauma. This can be due to a car accident, a fall, a physical blow to the abdomen, or a sports injury. Less frequently, it can be caused by an enlarged spleen.
With proper treatment and follow-up care, recovery from a ruptured spleen is typically excellent. Some people may be able to recover from a ruptured spleen with hospital care and recovery time. Others may require surgery to remove the damaged spleen.
If you’ve been injured and have symptoms of a ruptured spleen, seek emergency care right away.