Ruptured spleen

Diagnosis

Tests and procedures used to diagnose a ruptured spleen include:

• Physical exam. Your health care provider will press on your abdomen to determine the size of your spleen and whether it's tender.
• Blood tests. Blood tests will evaluate factors such as platelet count and how well your blood clots.
• Checking for blood in your abdominal cavity. In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery.
• Imaging tests of your stomach. If your diagnosis isn't clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms.

Treatment

Treatment for a ruptured spleen will depend on the seriousness of your condition. Severe injuries usually require immediate surgery.

Many small or moderate-sized injuries to the spleen can heal without surgery. You're likely to stay in the hospital while your health care team observe your condition and provide nonsurgical care, such as blood transfusions, if necessary.

You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

Surgery and other procedures

Surgery for a ruptured spleen can include:

• Repairing the spleen. Your surgeon might be able to use stitches or other techniques to repair the rupture.
• Removing the spleen, called a splenectomy. People can live without a spleen, but it increases the risk of serious bacterial infections such as sepsis. Your health care provider may recommend vaccinations against meningitis, pneumonia and haemophilus influenza, type b (Hib). Occasionally, you may be prescribed daily oral antibiotics to prevent infections.
• Removing part of the spleen. It might be possible to remove only part of your spleen, depending on the rupture. Partial splenectomy reduces the risk of infection that results from removing the entire spleen.

Spleen surgery is generally safe, but any surgery has risks, such as bleeding, blood clots, infection and pneumonia.