Ruptured spleen

Overview
Rupture of the capsule of the spleen, an organ in the upper left part of the abdomen, is a potential catastrophe that requires immediate medical and surgical attention.

Function of spleen
The spleen is an organ in the upper left side of the abdomen that filters the blood by removing old or damaged blood cells and platelets and helps the immune system by destroying bacteria and other foreign substances. It also holds extra blood that can be released into the circulatory system, if needed.

Clinical presentation

 * abdominal pain
 * pain in the left shoulder
 * hypotension
 * tachycardia

Prognosis
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 an urgent operation, although it is becoming more common to simply monitor the patient to make sure the bleeding stops by itself and to allow the spleen to heal itself. 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 major contact sports) where injury to the abdomen could be catastrophic.

Prevention
The spleen is a useful but nonessential organ. It is sometimes removed (otherwise known as a splenectomy) in people who have blood disorders, such as thalassemia or hemolytic anemia. If the spleen is removed, a person must get certain immunizations to help prevent infections that the spleen normally fights.

Related chapters

 * Infectious mononucleosis
 * Splenomegaly
 * Kehr's sign

Resources

 * BBC
 * BBC
 * BBC
 * BBC