The spleen, located on the left (postero-lateral)
side of the abdomen near the stomach, is an oval-shaped
organ that produces and maintains red blood cells
and produces certain white blood cells. The spleen
brings blood into contact with lymphocytes, which
attack foreign bodies or disease in the blood. It
also removes worn-out blood cells and disposes them
to other parts of the body, which flush them out.
The spleen performs many functions but none that
the body can do without. However, because it is
such a large reservoir for blood, damage to it can
lead to severe hemorraging and even death. A ruptured
spleen is a complex injury that must be diagnosed
and treated immediately, very likely by surgery.
If you suspect you may have a ruptured spleen, go
immediately to the nearest hospital’s emergency
room or call (or have someone call) for an ambulance.
Causes
A ruptured spleen is usually caused by a direct,
violent blow to the left side of the body or chest.
For active people, it usually is the result of collision
sports such as football and hockey. It can also
happen in serious falls and car and cycle accidents.
Considerations
A ruptured spleen is a very serious injury that
can cause massive internal bleeding and possibly
death. Splenectomy (removal of the spleen) is usually
done immediately in such cases.
There usually are three parts to a medical evaluation:
medical history, a physical examination, and tests
that your doctor may order. If your ruptured spleen
is a medical emergency, these exams and tests will
be done right away, just before you go into surgery.
MEDICAL
HISTORY
Your physician likely will ask about your activities,
which may have caused your ruptured spleen. You
will probably be asked when the soreness or pain
began. If you have had any prior injuries in the
area, your physician will ask about the treatments
you have tried in the past. Physicians also typically
ask about other conditions, such as diabetes and
allergies, and medications currently being taken.
Your physician will generally press or feel around
your chest and abdomen to test the extent of tenderness
you may be feeling. He also will listen for any
crackling sounds that may be coming from the area
as you breathe to look for evidence of associated
rib fractures. Evaluation of the left flank is also
done to look for bruising.
TESTS
X-rays or a CT scan will
likely be taken to determine the extent of the injury
to your spleen, as well as to rule out rib fractures
or other injuries in the area. A CT scan is usually
more useful than an X-ray. Blood and urine will
probably be taken to check for anemia, which may
not be evident if blood loss is not rapid. To look
for free blood in the abdominal cavity, abdominal
paracentesis, or abdominal lavage, may be done.
This involves inserting a large needle into the
mid-line of the abdomen.
