Examples of these other injuries include rib fractures , pelvic fracture, and spinal cord injury. The location of the spleen means that injury to this organ can cause pain in the upper-left part of the abdomen. However, after a rupture, pain can occur in other locations, such as the left chest wall and shoulder. This feels worse when the individual breathes in.
A ruptured spleen can cause pain in the left shoulder because bleeding from the spleen may irritate the phrenic nerve, a nerve that originates in the neck and extends through the diaphragm. Abdominal tenderness is the most common sign of an injury inside the abdomen but is not specific to spleen injury. These symptoms result from loss of blood and a drop in blood pressure.
There are two main types of treatment for a ruptured spleen: Surgical intervention and observation. Many people with a ruptured spleen experience serious bleeding that requires immediate surgery on the abdomen. The surgeon will cut open the abdomen and operate with a procedure called a laparotomy.
For people with less severe splenic rupture, doctors will often use observation instead of surgery. However, these individuals still require active treatment and usually need a blood transfusion. People that have a low-grade splenic rupture and no signs of other injuries in the abdomen will generally be hemodynamically stable.
This means that blood pressure will be close to normal. Up until fairly recently, treatment for a spleen injury usually involved complete removal of the spleen, or splenectomy. A non-operative approach to managing a splenic rupture is a modern development in adult trauma surgery and was adopted following its success in treating children without surgery.
Trauma surgeons used to routinely remove spleens when there was evidence of splenic rupture. Surgery is now avoided in 95 percent of children and 60 percent of adults that have a splenic rupture. When surgery is performed, it is still common practice to remove the entire spleen, although less severe cases may allow a surgeon to repair a tear and put pressure on the spleen until the bleeding stops. People who remain stable under observation will often undergo further scans for monitoring purposes, including CT scans.
Those in a stable condition may also undergo a procedure called splenic embolization. The procedure aims to stop any bleeding from the spleen. This procedure usually needs to be performed quickly and can help avoid the need to remove the spleen. Splenic embolization requires specialized facilities and staff, including a vascular surgeon or interventional radiologist. They need to be experienced in carrying out a certain type of artery catheterization and in performing embolization techniques.
This is known as a splenectomy. It is normally performed during an emergency laparotomy on a person in an unstable condition. In some cases of less severe spleen damage, the organ may be salvaged during surgery. Instead of being completely removed, it may be repaired with partial removal, patches, repairs, or staples.
There are, however, very limited opportunities for these options. It is important for a person to rest and allow the body time to heal, and only to resume normal activity after receiving the go-ahead from their treating doctor. People who play sports are advised that they can resume mild physical exertion for three months before resuming their usual training or exercise regimen.
This means that all individuals who have undergone a splenectomy should get vaccinated against Pneumococcus. High-risk patients should be vaccinated against Meningococcus and Haemophilus influenzae type B. These vaccinations are typically given 14 days before an elective splenectomy or 14 days after surgery in emergency cases. If you've been diagnosed with an enlarged spleen, ask your doctor whether you need to avoid activities for several weeks that could cause it to rupture.
These might include contact sports, heavy lifting and other activities that increase the risk of abdominal trauma. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Ruptured spleen Open pop-up dialog box Close. Ruptured spleen The spleen is located just under your rib cage on your left side.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references AskMayoExpert. Splenic injury. Mayo Clinic; Maung AA, et al. This is a relatively recent option and is not always available. Depending on the severity of the ruptured spleen and how stable the blood pressure is, the patient may have to have surgery. If the spleen is removed, the patient may have to take a series of vaccinations to boost immune function after surgery.
A ruptured spleen is a serious condition whether it comes from trauma or not. If you have left shoulder pain following an injury to the abdomen—especially if there wasn't any trauma to the shoulder—be sure to seek emergency medical care.
The most important treatment for a ruptured spleen is an early diagnosis. Whether the ruptured spleen is going to be treated with or without surgery, the earlier that decision can be made the better.
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Chirurgia Bucur. Updated October 1, Won A, Ethell A. Spontaneous splenic rupture resulted from infectious mononucleosis. Int J Surg Case Rep. Computed tomography of blunt spleen injury: a pictorial review. Malays J Med Sci. Zarzaur B, Rozycki G. An update on nonoperative management of the spleen in adults. Trauma Surg Acute Care Open. Updated May Updated April Akoury T, Whetstone DR. Splenic Rupture. In: StatPearls [Internet]. Spontaneous rupture of the spleen operated in gynecological unit mistaken for ruptured hemorrhagic ovarian cyst: total splenectomy.
Pan Afr Med J. Published Nov Patterson JW, Dominique E. Acute Abdomen. Pathological rupture of the normal spleen: Review with the literature. Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page.
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