What is Splenic Injury

Splenic injury is an injury of the spleen. The spleen is an organ located in the upper left area 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 also plays an important role in fighting disease.

Splenic injuries can vary. In some cases, the spleen may only be bruised, with some bleeding inside the covering and around the spleen.

Splenic injuries may also cause a deep tear or cut into the spleen (lacerated spleen). Some splenic injuries can cause the spleen to break open (rupture).

What are the causes?

This condition may be caused by a direct blow (trauma) to the spleen. Trauma can result from:

• Car accidents.
• Contact sports.
• Falls.
• Penetrating injuries. These can be caused by gunshot wounds or sharp objects such as a knife.

What increases the risk?

You may be at greater risk for a splenic injury if you have a disease that can cause the spleen to become enlarged. These include:

• Alcoholic liver disease.
• Viral infections, especially mononucleosis.
• Certain inflammatory diseases, such as lupus.
• Certain cancers, especially those that involve the lymphatic system.
• Cystic fibrosis.

What are the signs or symptoms?

Symptoms of this condition depend on the severity of the injury. A minor injury often causes no symptoms or only minor pain in the abdomen. A major injury can result in severe bleeding, causing your blood pressure to decrease rapidly. This in turn will cause symptoms such as:

• Dizziness or light-headedness.
• Rapid heart rate.
• Difficulty breathing.
• Fainting.
• Sweating with clammy skin.

Other symptoms of a splenic injury may include:

• Very bad abdominal pain.
• Pain in the left shoulder.
• Pain when the abdomen is pressed (tenderness).
• Nausea.
• Swelling or bruising of the abdomen.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history, especially if you were recently in an accident or you recently got hurt.
• A physical exam.
• Imaging tests, such as:
  • CT scan.
  • Ultrasound.

You may have frequent blood tests for a few days after the injury to monitor your condition.

How is this treated?

Treatment depends on the type of splenic injury you have and how bad it is.

• Less severe injuries may be treated with:
  • Observation.
  • Interventional radiology. This involves using flexible tubes (catheters) to stop the bleeding from inside the blood vessel.
• More severe injuries may require hospitalization in the intensive care unit (ICU). While you are in the hospital:
  • Your fluid and blood levels will be monitored closely.
  • You will get fluids through an IV as needed.
  • You may need follow-up scans to check whether your spleen is able to heal itself. If the injury is getting worse, you may need surgery.
  • You may receive donated blood (transfusion).
  • You may have a long needle inserted into your abdomen to remove any blood that has collected inside the spleen (hematoma).
• If your blood pressure is too low, you may need emergency surgery. This may include:
  • Repairing a laceration.
  • Removing part of the spleen.
  • Removing the entire spleen (splenectomy).

Follow these instructions at home:

Activity

• Rest as told by your health care provider.
• Avoid sitting for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Do not participate in any activity that takes a lot of effort until your health care provider says that it is safe.
• Do not take part in contact sports until your health care provider says it is safe to do so.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Stay up-to-date on vaccines as told by your health care provider.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Do not drink alcohol.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These may delay healing after an injury. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Get help right away if you have:

• A fever.
• New or increasing pain in your abdomen or in your left shoulder.
• Signs or symptoms of internal bleeding. Watch for:
  • Sweating.
  • Dizziness.
  • Weakness.
  • Cold and clammy skin.
  • Fainting.
• Chest pain or difficulty breathing.

Summary

• The spleen is an organ located in the upper left area of the abdomen, just under the ribs.
• A splenic injury is an injury of the spleen. This may be caused by a direct blow (trauma) to the spleen.
• You may be at greater risk for a splenic injury if you have a disease that can cause the spleen to become enlarged.
• A minor injury often causes no symptoms or only minor pain in the abdomen. A major injury can result in severe bleeding, causing your blood pressure to decrease rapidly.
• Treatment depends on the type of splenic injury you have and how bad it is.