Spleen Injuries Contusion, Laceration
Jamie & Keith AH 322 October 1, 2003
Abdominal Quadrants
Right Upper
– Liver, Pancreas, Kidney, and Lung
Right Lower
– Appendix, Ureter, Bladder, Colon, and Gonads
Left Upper
– Heart, Spleen, Kidney, Stomach, and Lung
Left Lower
– Ureter, Bladder, Colon, and Gonads
Spleen Function
The primary filtering element for the blood. Acts as a filter against foreign organisms that infect the blood stream. The site of red blood cell and platelet storage. Filters out old red blood cells and recycles them.
More About The Spleen
The spleen is the organ most often damaged in cases of abdominal trauma. Any injury to the spleen can cause severe internal hemorrhage and shock. If surgically removed, the liver and red bone marrow can take over the functions normally carried out by the spleen.
Still More About That Wonderful Spleen
During periods of high infection, the spleen may become enlarged, increasing its ability to become injured. Infectious mononeucleosis is the most likely cause of spleen enlargement.
Method of Injury
Blunt trauma Infection causes spleen to swell Increasing chance of contusion to spleen
Signs & Symptoms
History of blow to upper left quadrant Pale skin Light headed Blood pressure low Heart rate up Nausea Abdominal rigidity Pt tender in upper left quadrant but less tender if muscles are tense KEHR's sign-pain in left shoulder
What is a spleen laceration?
A significant tear that involves the main blood vessels to the spleen which causes complete destruction of the spleen.
Spleen Laceration
External lateral view of a spleen. Notice the normal slategray color of the spleen. Towards the right of this specimen, extending from the very top diagonally across to the bottom of the specimen, is a large tear in the capsule of the spleen, exposing the pulp. Splenic lacerations are common in automobile accidents and are particularly common if the spleen has undergone enlargement due to some reason.
Treatment
Monitor even if just had wind knocked out See MD if symptoms persist Nonoperative treatment is recommended with a week of hospitalization. No activity for three weeks. Can resume light activity at three weeks to full recovery at four weeks. If surgical repair is needed, then will require 3 months to recover, whereas spleen removal will require six months before the athlete can return to activity