Ruptured Spleen
Original Editors - Nick Hansen & Ren Peterson from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
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[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
(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[edit | edit source]
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Medications[edit | edit source]
No medications are prescribed to heal severe splenic ruptures, there are medications and vaccines recommended post-surgical removal of the spleen (splenectomy) in severe injuries.
The Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention (CDC) and the Society of Surgery for the Alimentary Tract recommends all patients that undergo splenectomy receive:
• the pneumococcal polysaccharide vaccine
• meningococcal vaccination
• considered for the Hib vaccine
• annual influenza vaccine in addition to the pneumococcal, meningococcal, and Hib vaccines, because secondary bacterial infections can lead to severe disease in this patient population
• boosters for all the bacterial vaccines every 5 years
(vaccines after splectomy)
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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