Ruptured Spleen

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Nick Hansen & Ren Peterson from Bellarmine University's Pathophysiology of Complex Patient Problems project.

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Definition/Description

The spleen is an organ of the lymphatic system located on the left side of your stomach (abdomen) under the rib cage and diaphragm in a region that is referred to as the left upper quadrant. In humans the spleen is about the size of a fist and its primary roles are filtering the body’s blood and helps to fight infection. It also serves a role in storing and releasing certain types of immune cells that mediate tissue inflammation (encyclopedia brittanica)

Rupturing a spleen describes an emergency situation in which your spleen has developed a break in its surface. This is serious condition that can occur during a direct blow or trauma and without emergency treatment a ruptured spleen can cause life threatening internal bleeding. (mayo clinic)

Prevalence

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Characteristics/Clinical Presentation

(Mayo Clinic) Signs and symptoms of a ruptured spleen include:
• Pain (usually severe but not always) in the upper left portion of the stomach (abdomen) or under rib cage
• Tenderness when you touch the upper left portion of the stomach (abdomen)
• Left shoulder pain-Kehr’s Sign

Kehr's sign (Hans Kehr (1862–1913), German surgeon] pain in the left shoulder caused by irritation of the  undersurface of the diaphragm by blood leaking from a ruptured spleen. The pain impulses are referred along the phrenic nerve supplying the diaphragm C3-C5 nerve distribution.

Internal bleeding due to a ruptured spleen can cause blood pressure to drop (hypotension). This can cause: (webmd)
• Blurred vision
• Confusion
• Light-headedness
• Fainting
• Signs of shock, including restlessness, anxiety, and paleness

It is strongly advised to seek immediate medical care if an injury is sustained coupled with pain in the left upper stomach (abdomen) region along with any of the above listed signs and symptoms. If severe injuries are untreated a ruptured spleen can be fatal.

Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

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Etiology/Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports/ Case Studies

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Resources

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Recent Related Research (from Pubmed)

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References

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