The spleen may be found in the upper-left quadrant of a person’s abdomen and is protected by the rib cage. The spleen is roughly in the shape of a fist, about four inches long, and is purplish in hue. The spleen has no sensation until the organ suffers some damage or becomes enlarged.
The spleen’s primary purpose is to filter blood as a component of a person’s immune system. The spleen filters out red blood cells from the bloodstream and recycles them. The spleen warehouses white blood cells and platelets as well. The human spleen plays a role in fighting off certain infections and is instrumental in fighting the bacteria that cause pneumonia and meningitis.
The spleen has a protective covering that is made out of muscle and has an elastic-like quality. Damage to the tissue that surrounds the spleen occurs when the person suffers a blunt-force injury to the abdomen. The spleen is also the most vulnerable organ in the stomach.
Auto accidents are the number one cause of ruptured spleens. The spleen can rupture when the abdomen collides forcefully with the steering wheel, seatbelt, or another object. However, ruptured spleens do not occur without another injury. Spleen injuries occur along with rib fractures, pelvic fractures (when the upper pelvic bone gets driven into the abdomen), or spine fractures.
Symptoms of a Ruptured Spleen
Following a car accident, a ruptured or injured spleen will present with severe pain in the upper-left area of the victim’s stomach. Pain in the upper-left part of the stomach is not the only symptom when the spleen ruptures. The ruptured spleen can send pain signals into the abdominal wall on the left side and pain shooting across the stomach and reaching up into the left shoulder.
Pain from a ruptured spleen that radiates to the left shoulder is known as Kehr’s sign. Pain in the shoulder increases along with a deeper breath. The Kehr’s sign is significant to doctors because it is an indicator of internal bleeding. The blood flowing from the ruptured spleen compresses the phrenic nerve which runs into the left shoulder from the neck and into the diaphragm.
Other symptoms of a ruptured spleen include lightheadedness, confusion, blurring vision, fainting spells, and signs of shock like increased anxiety, restlessness, loss of color in the face, and nausea. This list of symptoms indicates internal bleeding. Internal bleeding causes the pulse to rise, and the victim’s blood pressure to drop.
Repairing a Ruptured Spleen
Physicians can take one of two approaches. The first is a wait-and-see approach. Blood flowing from the spleen might clot and therefore stop on its own without medical intervention. The patient will require a blood transfusion to keep blood pressure and vital signs around average levels. People who remain stable despite having a ruptured spleen require repeated radiographs to confirm that the bleeding has stopped.
Many physicians advocate for the non-surgical option, if possible. Estimates suggest that 95% of children with ruptured spleens do not need surgery while 65% of adults can be managed without surgical intervention.
If the bleeding is severe and will not stop on its own, then surgery is indicated. Surgeons now have a couple of options available to them. Recent developments allow surgeons to either repair the tear in the spleen or cauterize the bleeding blood vessel whereas the only option was a splenectomy or complete removal of the organ, was once the only option. Splenectomy is necessary in emergency cases where the internal bleeding is so severe that the patient is not medically stable.
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