Ruptured spleen

Definition:
The spleen is a soft plum-coloured organ, packed with blood-filled tissues and covered by a smooth membrane. It’s located in the abdomen just beneath the left side of the diaphragm, under the ribs, and is shaped like a loosely clenched fist.
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The spleen’s vulnerable location and softness means it’s at risk of injury. A severe blow to the stomach area can squash the spleen, splitting or tearing its covering membrane and the tissue inside and allowing blood to rapidly leak out – rather like a squashed tomato.

A ruptured spleen is a serious condition that can occur when your spleen experiences a trauma. With enough force, a blow to your abdomen — during a sporting mishap, a fistfight or a car crash, for example — might lead to a ruptured spleen. Without emergency treatment, a ruptured spleen can cause life-threatening internal bleeding.

Though some ruptured spleens require emergency surgery, others with ruptured spleens can be treated with several days of hospital care.

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Symptoms
The abdomen usually feels tender and painful when the spleen ruptures. Blood leaks into the abdomen, causing irritation with subsequent tenderness and pain. Classically, a patient with a ruptured spleen describes feeling left shoulder-tip pain (this pain comes from irritation of the diaphragm by the spilt blood).

If the leak of blood is gradual, symptoms may not occur until the blood supply to the body is diminished. This will result in low blood pressure and light-headedness, blurred vision, confusion and loss of consciousness, as the oxygen supply to the heart and brain is affected. If blood loss is rapid, the person may suddenly collapse.

Causes:
A ruptured spleen is the most common serious complication of an abdominal injury and may occur as a consequence of road traffic accidents, sports injuries and violent, physical attacks.

*Injury to the left side of the body. A ruptured spleen is typically caused by a blow to the left upper abdomen or the left lower chest, such as might happen during sporting mishaps, fistfights and car crashes.

*An injured spleen may rupture soon after the abdominal trauma or, in some cases, days or even weeks after the injury.An enlarged spleen. Your spleen can become enlarged when blood cells accumulate in the spleen. An enlarged spleen can be caused by various underlying problems, such as mononucleosis and other infections, liver disease and blood cancers.

Complications: A ruptured spleen can cause life-threatening bleeding into your abdominal cavity.

Diagnosis:
Normal procedures  to diagnose a ruptured spleen include:

*A physical exam. During a physical exam  doctor will use his or her hands to place pressure on your abdomen to determine the size of your spleen and whether you’re experiencing any abdominal tenderness.

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*Drawing fluid from  abdomen.  The Doctor may use a needle to draw a sample of fluid from the abdomen. If the sample reveals blood in the abdomen,  the patient may be referred for emergency treatment.

*Imaging tests of  the abdomen. If your diagnosis isn’t clear, the doctor may recommend an abdominal computerized tomography (CT) scan or another imaging test to identify or rule out other possible causes as per symptoms.

Treatment :
Untreated, a ruptured spleen can be rapidly fatal, so it requires urgent medical and surgical treatment.

Fluids must quickly be given through an intravenous drip in order to maintain the circulation to the organs of the body (including a blood transfusion) and emergency surgery is performed to stop the leak of blood.

Sometimes, if the rupture is only small, it’s possible for the surgeon to repair the spleen. However, usually the entire spleen needs to be removed in an operation called a splenectomy.

The spleen plays an important part in protecting the body against infection. In particular it clears a type of bacteria known as pneumococcus from the body. So it’s important that those who’ve had their spleen removed take extra precautions to protect themselves against infection. In particular, they should be vaccinated against pneumococcal infection.

Prognosis:
Splenic rupture permits large amounts of blood to leak into the abdominal cavity, possibly resulting in shock and death. Patients typically require emergency surgery, although it is becoming more common to simply monitor the patient to make sure the bleeding stops by itself and to allow the spleen to heal itself. Rupture of a normal spleen can be caused by trauma, for example, in an accident. If an individual’s spleen is enlarged, as is frequent in mononucleosis, most physicians will not allow activities (such as contact sports) where injury to the abdomen could be catastrophic.

Prevention
The spleen is a useful organ and it is essential to life. It is sometimes removed (splenectomy) in those who have blood disorders, such as thalassemia or hemolytic anemia. If the spleen is removed, a person must receive certain immunizations to help prevent infections that the spleen normally fights.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/rupturedspleen1.shtml
http://en.wikipedia.org/wiki/Ruptured_spleen
http://www.mayoclinic.com/health/ruptured-spleen/DS00872

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