Ruptured spleen

Overview

A ruptured spleen is a medical emergency that occurs as a result of a break in your spleen's surface. Your spleen, situated just under your rib cage on your left side, helps your body fight infection and filter old blood cells from your bloodstream.

A forceful blow to your stomach — during a sporting accident, a fistfight or a car crash, for example — is the usual cause of a ruptured spleen. If you have an enlarged spleen, a less forceful trauma might cause rupture. Without emergency treatment, the internal bleeding caused by a ruptured spleen can be life-threatening.

Some people with ruptured spleens need emergency surgery. Others can be treated with several days of hospital care.

Symptoms

Signs and symptoms of a ruptured spleen include:

• Pain in the upper left stomach.
• Tenderness when you touch the upper left stomach.
• Left shoulder pain.
• Confusion, lightheadedness or dizziness.

When to see a doctor

A ruptured spleen is a medical emergency. Seek emergency care after an injury if your signs and symptoms indicate that you may have a ruptured spleen.

Causes

A spleen can rupture due to:

• Injury to the left side of the body. A ruptured spleen is typically caused by a blow to the left upper stomach or the left lower chest, such as might happen during sporting accidents, fistfights and car crashes. An injured spleen can rupture soon after the stomach trauma or, in some cases, days or weeks after the injury.
• An enlarged spleen. Your spleen can become enlarged when blood cells accumulate in the spleen. An enlarged spleen can be caused by various underlying problems, such as mononucleosis and other infections, liver disease, and blood cancers.

Risk factors

If the spleen is already enlarged due to infection or another cause, there is increased risk that the spleen might rupture. Contact sports that involve blows to the chest also increase the risk of a ruptured spleen.

Complications

A ruptured spleen can cause life-threatening bleeding into your stomach cavity.

Prevention

If you've been diagnosed with an enlarged spleen, ask your health care provider whether you need to avoid activities for several weeks that could cause it to rupture. These might include contact sports, heavy lifting and other activities that increase the risk of stomach trauma.