SPLEEN RUPTURE |
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General Information
DEFINITION--Injury to the spleen, causing it to rupture. Bleeding of a ruptured spleen can be fatal. The spleen is vulnerable to injury, particularly if it is enlarged due to any underlying disorder (infectious mononucleosis is the most common). Spleen injuries are infrequent in athletes but, when they do occur, they can be disastrous.
BODY PARTS INVOLVED
Spleen.
Muscles of the abdominal wall.
Peritoneum (membranous covering to the intestines).
Ribs (sometimes) if fractured at the same time the spleen is injured.
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SIGNS & SYMPTOMS
Recent injury to the abdomen or flank.
Rib fracture on the left side.
Vomiting.
Abdominal pain and tenderness.
Pain in the left shoulder or left side of the neck.
Rapid heart rate.
Low blood pressure.
Other signs of shock: pale, moist and sweaty skin; anxiety with feelings of impending doom; shortness of breath and rapid breathing; disorientation and confusion.
CAUSESDirect injury to the left upper abdomen or left side of the chest.
RISK INCREASES WITH
Contact sports.
Bleeding disorders such as hemophilia.
Infectious mononucleosis or any other illness that causes spleen enlargement.
If surgery is necessary, surgical risk increases with smoking, use of mind-altering drugs, muscle relaxants, tranquilizers, sleep inducers, insulin, sedatives, beta-adrenergic blockers or corticosteroids.
HOW TO PREVENTAvoid causes and risk factors when possible. Don't return to athletic activities until a spleen enlarged by disease has returned to normal.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's exam. When abdominal symptoms follow a blow to the abdomen, it is imperative that a diagnosis be established as soon as possible. Injury to any organ in the abdomen (spleen, liver, intestines, kidney, bladder, pancreas) causes an acute surgical emergency.
Hospitalization for intravenous fluids or transfusions to treat shock.
Surgery under general anesthesia to remove the ruptured spleen.
DIAGNOSTIC MEASURES
BEFORE SURGERY:
Blood and urine studies.
X-rays of the abdomen and chest.
AFTER SURGERY:
Examination of all removed tissue.
Additional blood studies.
POSSIBLE COMPLICATIONS
AT THE TIME OF INJURY:
Rapid deterioration due to internal bleeding, possibly leading to death.
FOLLOWING SURGERY:
Excessive bleeding.
Infection.
Incisional hernia.
Lung collapse.
Inflammation of the pancreas.
Deep-vein blood clots.
Pneumonia.
PROBABLE OUTCOMEExpect complete healing if no complications occur. Allow about 4 weeks for recovery from surgery.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDCover the victim with a blanket to combat shock, and take to the nearest emergency facility. Do not give water, food or pain relievers.
CONTINUING CARENo specific instructions except those under other headings. If surgery is required, your surgeon will supply postoperative instructions.
MEDICATION
Do not give pain relievers at the time of injury. They may mask symptoms.
After surgery, your doctor may prescribe:
Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
Antibiotics to fight infection.
Pneumonia vaccinations.
Stool softeners to prevent constipation.
Non-prescription drugs such as acetaminophen for minor pain.
ACTIVITY
Return to work, play and normal activity as soon as possible. This reduces postoperative depression, which is common.
Avoid vigorous exercise for 6 weeks after surgery.
Resume driving 4 weeks after returning home.
DIET
No food or water before surgery.
Drink a clear liquid diet until the gastrointestinal tract functions again. Then eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONRehabilitation exercises must be individualized. Follow your doctor's or surgeon's directions.
CALL YOUR DOCTOR IF
You receive any abdominal injury and the symptoms last longer than a few minutes, worsen, or recur within hours or days. This may be an emergency!
Any of the following occur after surgery:
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
Pain, swelling, redness, drainage or bleeding increases in the surgical area.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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