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Ruptured Spleen

Definition :
A ruptured spleen is a serious condition. Without emergency treatment, a ruptured spleen can cause life-threatening bleeding.

Your spleen is located just under your rib cage on your left side, a prime spot for injury. With enough force, a blow to your abdomen — during a sporting mishap, a fist fight or a car accident, for example — might lead to a ruptured spleen.

The spleen helps your body fight infection and filter unwanted material, such as old or damaged blood cells. The spleen also produces red blood cells and certain types of white blood cells. A ruptured spleen may pour a large amount of blood into your abdominal cavity.

If the rupture is small, surgical repair may be possible. Typically, however, the entire spleen is removed in emergency surgery.

A ruptured spleen is typically caused by a blow to the left upper abdomen or the left lower chest. Sporting mishaps, fist fights and car accidents are common triggers. An injured spleen may rupture soon after the abdominal trauma or, in some cases, days or even weeks after the injury.

An enlarged spleen — which may be caused by various underlying problems, from mononucleosis and other infections to liver disease and blood cancers — may sometimes rupture with trauma to the abdomen. In fact, a ruptured spleen is the most significant complication of mononucleosis.

When to seek medical advice :
A ruptured spleen is a medical emergency. If you have pain in the left upper abdomen or signs and symptoms of low blood pressure — such as lightheadedness, confusion, blurred vision or fainting — following an injury, seek emergency medical care.

Abdominal pain and tenderness are the classic symptoms of a ruptured spleen. If internal bleeding causes your blood pressure to drop, you may become lightheaded or confused. Blurred vision and fainting are possible as well.

In a critical situation, a physical exam may be the only diagnostic test before emergency surgery. In other cases, a sample of fluid from your abdomen may be tested for the presence of blood. If time allows, the doctor may use X-rays or other imaging tests to identify or rule out other possible causes of your symptoms.

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

If the rupture is small, surgical repair may be possible. Typically, however, the entire spleen is removed in an emergency surgery known as a splenectomy. Many elective splenectomies are done with a small incision and a slender tube equipped with a camera lens and light (laparoscope), but emergency surgery may require an open procedure. If you've lost a large amount of blood, you may need transfusions to improve your circulation.

You can live an active life without a spleen, but you're more likely to contract serious or even life-threatening infections. If your spleen is removed, your doctor may recommend a pneumonia vaccine, as well as yearly flu vaccines. In some cases, preventive antibiotics may be recommended as well — especially if you have any other conditions that increase your risk of serious infections.

After a splenectomy, notify your doctor at the first sign of an infection. Make sure anyone caring for you knows that you had your spleen removed.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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