Splenic Injury

ExitCare ImageA splenic injury is an injury to the spleen. The spleen is an organ located in the upper left side of the abdomen, just under the ribs. The spleen filters and cleans the blood. It also stores blood cells and destroys cells that are worn out. The spleen is involved in fighting disease. However, when the spleen is removed, your body can still fight most diseases without it.

CAUSES

A blow to the abdomen can injure the spleen. In some cases, the spleen may only be bruised with some bleeding inside the covering and around the spleen. However, sometimes an injury to the spleen causes it to break (rupture). Illness can also cause the spleen to become enlarged and rupture. Because the spleen has a lot of blood going to it, a rupture is very serious and can be life-threatening.

SYMPTOMS

Often, a minor splenic injury causes no symptoms or only minor abdominal pain. When bleeding from the injury is severe, the patient's blood pressure may rapidly decrease. This may cause some of the following problems:

  • Dizziness or lightheadedness.

  • Rapid heart rate.

  • Abdominal tenderness and swelling.

  • Fainting.

  • Sweating with clammy skin.

DIAGNOSIS

Your caregiver may immediately know what is wrong by taking a history and doing a physical exam. If there is time, the diagnosis is often confirmed by a CT scan. Other imaging tests may also be done, such as an ultrasound exam or sometimes an MRI scan. Lab tests may be done to check your blood and may be needed frequently for a couple days after the injury.

TREATMENT

  • If the blood pressure is too low, emergency surgery may be needed.

  • When injuries are less severe, your surgeon may decide to observe the injury, or to treat the injury with interventional radiology. Interventional radiology uses flexible tubes (catheters) to stop the bleeding from inside the blood vessel. It can only be used under certain circumstances. Your caregiver will tell you if this is an option.

  • One to several days in an intensive care unit (ICU) may be required. Fluid and blood levels will be monitored closely. Intravenous (IV) fluids and blood transfusions are sometimes needed. Follow-up scans may be used to check how the spleen is healing. The spleen may be able to heal itself. However, if the  problems are getting worse, surgery may still be needed.

HOME CARE INSTRUCTIONS

  • Keep all follow-up appointments as instructed by your caregiver. Even when the spleen appears to have healed well, your surgeon may want to continue following up on the injury.

  • Ask your caregiver if you need any immunizations. You may need certain immunizations depending on whether you had surgery, interventional radiology, or some other treatment for your spleen injury.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a fever.

  • Your abdominal pain gets worse.

  • You develop signs of infection, such as chills and feeling unwell.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.