Rupture of the capsule of the spleen (an organ in the upper left part of the abdomen, just under the rib cage) – is a situation that requires immediate medical attention that occurs when the capsule-like covering of the spleen breaks open, pouring blood into the abdominal area. Depending on the size of the rupture, a large amount of internal bleeding can occur. The rupture itself can be caused by trauma, such as a motor vehicle accident or a forceful blow to the abdomen.
Symptoms of a ruptured spleen include:
- Pain in the upper left portion of the abdomen;
- Tenderness when you touch the upper left portion of the abdomen;
- Drop of the blood pressure due to the internal bleeding;
- Blurred vision;
- Signs of shock, including restlessness, anxiety, nausea, and paleness
In minor injuries with little bleeding, there may be abdominal pain, tenderness in the epigastrium and pain in the left flank. Often there is also a sharp pain in the left shoulder, known as the Kehr's sign. In larger injuries with more extensive bleeding, signs of hypovolemic shock are most prominent. This might include a rapid pulse, low blood pressure, rapid breathing, paleness and anxiety. The severity and even the location of the pain depend on how badly the spleen has ruptured and how much blood leaks out. Pain may be felt in these locations:
- Left side of the abdomen under the rib cage
- Left shoulder, because nerves of the left shoulder and left side of the diaphragm originate from the same location and the rupture may irritate these nerves
A spleen may rupture due to:
- Injury to the left side of the body;
- An enlarged spleen
The most common cause of a ruptured spleen is blunt abdominal trauma, such as in traffic, sports accidents or direct and penetrating injuries. Non-traumatic causes are less common. These include infectious diseases, medical procedures such as colonoscopy, haematological diseases, medications, and pregnancy.
A ruptured spleen can cause life-threatening bleeding into the abdominal cavity. Because a splenic rupture permits large amounts of blood to leak into the abdominal cavity, it can result in shock and death.
If a person is diagnosed with an enlarged spleen, he/she should ask the doctor whether to avoid activities that could cause a ruptured spleen. For instance, people with mononucleosis may be asked to avoid contact sports and other activities that increase the risk of abdominal trauma for several weeks. Protecting the spleen from bumps and blows may reduce the risk of a ruptured spleen.