Have you ever thought about the small organ on the left side of your abdomen, just below your ribs? This is what we call the spleen. It's about the size of the palm of your hand. But it does a great job. But sometimes this spleen can get injured and rupture. If that happens, it can be a bit serious.
What is the spleen? What does it mean if it ruptures?
Simply put, your spleen is a small, but very important organ located on the left side of your upper abdomen, about the size of a fist. It works like a filter. It holds about a quarter of the blood in our body at any given time, cleaning it, and storing red blood cells and platelets. It also helps make white blood cells that fight disease. The spleen is a sac-like organ inside, covered by a thin layer of tissue. Blood vessels also run through it.
However, with the location of the spleen, especially if it receives a hard blow, it is more likely to be injured. If the outer covering that I mentioned is torn or ruptured, that is what we call a 'splenic rupture' . If the spleen ruptures, compared to other organs inside our abdomen, there is a higher chance of bleeding into the body, which can be life-threatening. Therefore, a splenic rupture is an emergency that requires immediate medical attention. Sometimes, an operation may be necessary.
What are the causes of a ruptured spleen?
Okay, now let's see why the spleen ruptures like this.
Most of the time, the main reason for this is an injury from an accident. Imagine, for example, a car accident. About 50% to 75% of such accidents can result in a ruptured spleen. The same goes for injuries that occur while playing sports. This can happen especially in sports that involve body-to-body contact, such as rugby. Sometimes, the spleen can rupture from something as serious as a hard blow, a knife stab, or a gunshot wound.
The important thing is that sometimes the spleen can rupture immediately after the accident. But sometimes, some time after the accident, the wound swells and the spleen can rupture. This is called 'Delayed Rupture'.
Can a spleen rupture without causing any harm?
Now you might think that unless there is an accident, nothing will happen to the spleen. But, although rare, the spleen can rupture spontaneously without any accident. This is a bit surprising to hear, isn't it?
This happens when the spleen starts to swell due to another underlying medical condition in the body. As it swells, that outer covering I mentioned earlier gradually weakens, and eventually it can rupture.
Some conditions that can cause the spleen to swell include:
- Types of cancer, for example `(Lymphoma)`.
- Infections, such as `(Mononucleosis)` or `(Malaria)`.
- Chronic inflammatory diseases , such as hepatitis, a liver disease, or pancreatitis.
How does it feel when your spleen ruptures?
Okay, now let's see what it feels like if your spleen ruptures.
The spleen, as I said, is located in the upper left side of your abdomen, just below your left rib cage and diaphragm. When the spleen ruptures, you may feel a sharp pain in that area.
But there's something else here. The same accidents that cause a ruptured spleen can also cause other injuries, right? For example, you could break a rib. Then, you might not be able to distinguish the pain from a ruptured spleen from the pain from other injuries.
After a ruptured spleen, you may feel pain radiating to your left chest or shoulder. This is called Kehr's sign . This happens because when the spleen bleeds, the blood presses on a nerve that runs from your neck down through your left chest (the left phrenic nerve). You may feel the pain getting worse when you breathe.
Are there other symptoms of a ruptured spleen?
In addition to pain, you may experience other symptoms due to internal bleeding and a sudden drop in blood pressure. See if these sound familiar:
- Dizziness or lightheadedness
- Mental confusion or disorientation
- Blurred vision
- Paleness and faintness
- Restlessness or anxiety
- Nausea
What happens if the spleen ruptures? What should be done?
Imagine you have severe pain in the upper left side of your abdomen, or you have that Kehr's sign I mentioned. If these symptoms occur even after a short time after the accident, you should go straight to the Emergency Room (ER). Call an ambulance if necessary.
There, you will need to tell the doctors about your symptoms, any recent accidents, any infections you have, or any chronic diseases you have. The medical team will assess your condition and work to stabilize you, including giving you a blood transfusion if necessary.
How do you know if your spleen has ruptured?
Okay, now let's see how doctors figure this out.
First, if your condition is stable (meaning things like blood pressure and heart rate are close to normal), the medical team will examine you step by step. First, they will do a physical examination. Then they will refer you to imaging tests, such as scans.
But if you're injured in an accident and come to the emergency room, the medical team will first do a special bedside ultrasound. This is called a ``FAST ultrasound.'' This checks to see if there's any bleeding inside your abdomen.
If the FAST ultrasound confirms bleeding, and your vital signs are unstable, the medical team knows that your spleen has ruptured and needs immediate treatment.
Even if your condition is stable, if there is a suspicion that you have a spleen injury, they will often do a ``CT scan`` . This can take a good look at the spleen and the extent of the injury. The injury is then graded from I to V, depending on the severity of the injury.
How is a ruptured spleen treated?
The treatment for a ruptured spleen depends on the severity of the injury. Some minor lacerations may stop bleeding on their own. However, others may require emergency treatment. Very severe (Grade V) lacerations require a splenectomy to remove the spleen. However, a severe splenic injury may not be immediately apparent. Sometimes, a stable patient may become unstable after a few hours because of increased bleeding.
Here are some of the main methods of treating a ruptured spleen:
- Embolization: This procedure can help control bleeding in Grade III and IV splenic injuries, either before or instead of surgery. Embolization is a non-surgical procedure. It is performed by an interventional radiologist. Using radiology imaging techniques, a small tube (catheter) is inserted into a blood vessel and a small sponge-like bead is inserted into it to stop the bleeding.
- Splenorrhaphy: For Grade III or IV injuries, this may be done in addition to embolization. Splenorrhaphy is a surgical procedure to repair the spleen. This may involve suturing the wound, using electrocautery, or applying topical agents to stop bleeding. If successful, this can avoid the need to remove part or all of the spleen.
- Splenectomy: If severe bleeding cannot be controlled in any other way, and there is no way to save the spleen, part or all of the spleen may need to be removed. This is the case for about 20% of splenic ruptures. Since this is an emergency surgery, it is usually done as an open abdominal surgery. This will make it easier for the surgeon to manage your emergency.
What are the chances of surviving a ruptured spleen?
This really depends on how bad your wound is and how quickly you find and treat it. A small cut will bleed slowly, slowly. So you have some time, but it can easily be missed. If it's bleeding heavily, the symptoms will be obvious, but it's very dangerous. If it's bleeding badly inside the body, death can occur within a few hours if not treated immediately. So this is not something to take lightly.
How long does it take to heal from a ruptured spleen?
Depending on the size of your injury and the treatment you received, it can take anywhere from three to twelve weeks to heal. If you have had surgery, you will likely need to stay in the hospital for a few days afterward. After an open surgery, there is a large incision to heal. You may be given pain medication when you go home. On the other hand, minor sprains heal relatively quickly.
How should I take care of myself while living without a spleen?
Yes, you can live without your spleen. But it affects your immune system. Because the spleen is an important organ that protects against infections, you may be slightly more susceptible to illness after having your spleen removed (splenectomy).
Your surgeon will recommend several special vaccines to protect you from infections both in the hospital and after you go home. He or she will also advise you to take antibiotics immediately if you develop an infection.
In summary, what we need to remember (Take-Home Message)
Okay, so this is the most important message we need to take home from all of this talk.
Whether a ruptured spleen is minor or major, it is an emergency. Internal bleeding can be life-threatening if not managed properly.
However, the good news is that most splenic ruptures, if recognized and treated early, can be managed with simple measures that can save the spleen. But this depends on how quickly you recognize and treat your injury.
If you have even the slightest suspicion that you have an injury to your spleen, the best thing to do is to seek medical advice immediately and have it checked for bleeding.
` Spleen, Spleen rupture, Ruptured Spleen, Internal bleeding, Abdominal pain, Emergency treatment, Kehr's sign
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න