Located on the left side of the body below the ribs, the spleen recycles old blood cells and fights infection. A ruptured spleen is considered a medical emergency, and it typically develops after a car accident, injury, or other activities that could involve a heavy blow to the upper left part of the abdomen. Occasionally, patients who have an enlarged spleen due to mononucleosis or another medical condition may also experience a ruptured spleen.
Some of the most common symptoms of a ruptured spleen include pain in the upper left part of the abdomen and pain in the left shoulder. Some patients with a ruptured spleen may have cuts and bruises on the left side of the chest, and they might experience confusion, dizziness, or lightheadedness. To diagnose a ruptured spleen, doctors use physical exams, blood tests, ultrasounds, and imaging studies. Since a ruptured spleen can cause life-threatening internal bleeding, patients with this condition are closely monitored in the hospital.
The following methods are recommended for the prevention and treatment of a ruptured spleen.
Avoid High-Impact Activities And Contact Sports
Patients who are at a high risk of a ruptured spleen may need to avoid high-impact activities and contact sports. This is particularly important for patients who have an enlarged or bruised spleen due to accidents or conditions such as cancer, mononucleosis, or some other infections. Doctors normally advise at-risk patients to avoid football, rugby, and similar sports involving tackling or a risk of being hit by a ball. Since many ruptured spleens happen due to car accidents, it is recommended for patients to always wear a seatbelt while riding in a car. If a patient has been placed on restrictions from certain sports, the doctor will monitor the spleen and inform the patient when they can safely return to exercise.
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Avoid Heaving Lifting
Heavy lifting may cause trauma to the spleen that could result in a rupture. Patients at a higher risk of developing a ruptured spleen should pay particular attention to this. In particular, patients should avoid lifting more than twenty pounds, and they should ask for help when lifting items. To move items, patients could consider using a cart or pulley system. If a patient experiences any pain in the upper left side of their abdomen after lifting an item, especially if the abdomen is tender to the touch, he or she should visit the doctor promptly. Patients who have been lifting objects, even lightweight ones, should be vigilant for any symptoms such as fast heart rate, lightheadedness, dizziness, confusion, or pain in the shoulders. If these symptoms or any new changes develop, patients should have a complete evaluation from a physician.
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Treat An Enlarged Spleen Promptly
To prevent a ruptured spleen, doctors often try to treat an enlarged spleen promptly. To diagnose an enlarged spleen, the physician will do a physical exam to measure the size of this organ and check whether it can be felt. If the physician suspects the spleen is enlarged, this can be confirmed by an ultrasound or other imaging studies. Treatment for an enlarged spleen depends on the exact cause. If the enlarged spleen is due to bacterial infections, antibiotics may be given. If it is due to malaria or other parasitic infections, treating these infections can reduce the size of the spleen. If patients have no symptoms, physicians may recommend watchful waiting. This simply involves having follow-up appointments every six months to monitor the spleen's size. For some patients, clinicians may recommend treating an enlarged spleen with surgical removal of the organ.
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In cases where the spleen has been lacerated or otherwise injured, doctors may be able to use surgical repair. Surgical repairs are performed under general anesthesia, and they are often done as emergency procedures. During these procedures, surgeons will attempt to repair any tears in the spleen through the use of stitches, staples, and other surgical techniques. These repairs can stop any internal bleeding that may be occurring. During an operation to repair the spleen, doctors may discover the organ is too badly damaged for a repair to be viable. In this case, they will likely proceed with the removal of the spleen instead. Prior to having a repair procedure, patients will be informed it may be necessary to remove the spleen during the operation, and they will be asked to sign a consent form saying they agree to removal if it is required.
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Full Or Partial Splenectomy
A full or partial splenectomy may be recommended for patients who have a ruptured spleen. This surgery removes all or part of the spleen. Depending on the extent of a patient's internal bleeding, it may sometimes be necessary to perform this operation as an emergency procedure. Occasionally, some types of ruptures may allow the surgeon to perform only a partial splenectomy, and this decreases the risk of infection patients face if a full splenectomy is required. Both procedures are performed using general anesthesia, and they can typically be completed with laparoscopic methods that use only two or three small incisions. After a splenectomy, patients will be at an elevated risk of infections, including sepsis. Children and young adults are at an increased risk of infections after this procedure. To reduce the risk of infections, doctors generally advise that patients receive vaccinations for pneumonia, meningitis, and influenza. These are normally given two weeks prior to an elective splenectomy, and they may also be given two weeks following an emergency procedure. Patients may also need to take antibiotics on a daily basis after their surgery. Anyone who has had a splenectomy should inform all doctors and healthcare professionals about this since it can impact treatment options and general care.