Ruptured spleen: Causes, Symptoms, Treatment and Cost

A ruptured spleen is a medical condition in which the spleen, an organ located in the upper left area of the abdomen, is torn or ruptured.Medical help is required right away since this situation might be fatal.

• Traumatic rupture: This type of rupture is caused by a direct injury or trauma to the spleen, usually from a car accident or fall. It can cause severe internal bleeding and requires immediate medical attention.
• Splenic infarction: This type of rupture is caused by a blockage in the main artery that supplies blood to the spleen, leading to tissue death and eventual rupture. This type of rupture usually occurs in individuals who have an underlying medical condition such as sickle cell anaemia, thalassemia or leukaemia.
• Spontaneous rupture: This type of rupture is more rare and is often caused by a tumour on the spleen that eventually causes it to burst. It can also be caused by an infection or inflammation of the spleen, such as due to mononucleosis.

• Traumatic Injury: The most common cause of a ruptured spleen is a traumatic injury, such as a motor vehicle accident, a fall from heights, or physical abuse.The spleen may rip or rupture in these circumstances due to the power of the hit.
• Medical Conditions: Certain medical conditions can increase the risk for a ruptured spleen. These include blood clotting disorders such as haemophilia, certain types of infections such as HIV/AIDS, and diseases such as liver cirrhosis and cancer.
• Iatrogenic Injury: Iatrogenic injury is an injury caused by medical treatment or procedure, and it can cause a ruptured spleen in rare cases. This could occur during certain types of abdominal surgery or during procedures that involve inserting instruments into the abdomen, such as endoscopy or laparoscopy.

• Sudden and severe abdominal pain: A ruptured spleen usually causes sudden and severe abdominal pain, especially in the left upper side of the abdomen.
• Pain in the left shoulder: The pain may also radiate to the left shoulder and often worsens with deep breaths or movement.
• Abdominal tenderness: The area around the spleen may be tender to the touch. This is due to internal bleeding that occurs when the spleen ruptures.
• Nausea and/or vomiting: Nausea and vomiting are common symptoms of a ruptured spleen.
• Lightheadedness: Lightheadedness can occur due to a sudden drop in blood pressure as a result of internal bleeding from a ruptured spleen.
• Shortness of breath: As blood pressure continues to drop, a person with a ruptured spleen may experience shortness of breath or difficulty breathing.
• Fainting or passing out: If a person's blood pressure drops too low, they may faint or pass out as their body struggles to maintain an adequate supply of oxygen to their brain and other organs

• Wear a Seatbelt: Wearing a seatbelt is one of the best ways to prevent a ruptured spleen in the event of a car accident. The seatbelt acts as a barrier and helps to keep the body in place, reducing the risk of blunt force trauma to the spleen.
• Participate in Safe Contact Sports: Participating in contact sports can put you at risk for injury, so it is important to practise safe habits while playing sports. Wear all recommended protective gear, obey all rules and regulations, and be aware of your surroundings so you can avoid unnecessary collisions or falls that could lead to rupture of the spleen.
• Avoid Binge Drinking: Alcohol consumption can increase the risk of injury due to its effects on coordination, concentration and judgement. Heavy drinking can also cause liver damage which can weaken the abdominal wall leading to increased risk for rupture of the spleen.
• Strengthen Your Core: Regularly strengthening your core muscles such as your abdominal muscles will help provide additional support for your organs including your spleen. This will help reduce the risk for rupture if you are involved in an accident or if you experience direct trauma to your abdomen area.

• Physical exam: A physical exam can help diagnose a ruptured spleen, as the doctor will be able to feel if there is any tenderness or pain in the abdomen.Ultrasound: If the spleen is big, or if it has any rips or abrasions, an ultrasound may assist
• Identify such conditions.CT scan: A CT scan can help diagnose a ruptured spleen by showing any bleeding, fluid collection, and tissue damage in the abdomen and spleen area.MRI: An MRI can provide detailed images of the organs in the abdomen, which can help diagnose a ruptured spleen.
• Angiography: An angiography involves injecting a special dye into an artery and then taking X-ray images to determine if there is any bleeding in the area of the spleen.Laparoscopy: This procedure involves inserting a thin tube with a camera into the abdomen through a small incision to examine and possibly repair any damage to the spleen or other organs in the area.

• Haemorrhage: Ruptured spleen can cause excessive bleeding and internal haemorrhage, which can be life-threatening.
• Infection: Since the spleen is an organ that helps to filter out bacteria from the blood, a ruptured spleen can cause an infection to spread throughout the body.
• Shock: Blood loss due to a ruptured spleen can lead to shock, which can be fatal if not treated quickly.
• Organ Damage: The liver, pancreas, and kidneys may all sustain damage from a burst spleen. This can lead to further complications and even death if left untreated.
• Long-term Complications: Even after treatment for a ruptured spleen, some people may still experience long-term complications such as fatigue, anaemia and an increased risk of infection due to a weakened immune system.

• Consume medicinal herbs such as Ashwagandha, Guduchi, Amla and Shatavari to strengthen the spleen.
• Take herbal decoctions like Punarnava, Gokshura and Manjishtha to reduce inflammation and pain of the spleen.
• Consume dietary supplements like Amalaki powder and wheatgrass juice to support the spleen.
• For pain and inflammation alleviation, apply a paste made of turmeric powder to the afflicted region.
• Drink a mixture of honey and fresh lemon juice to help restore strength in the spleen.
• Massage with Brahmi oil or Mahanarayan oil to reduce swelling in the spleen area.
• Have warm water with a teaspoon of ginger juice for reducing inflammation in the spleen area.

• Foods that are soft, low-fat, and easy to digest are the best for those with a ruptured spleen.
• Eating foods such as applesauce, mashed potatoes, cooked cereal, custards, and eggs can help promote healing and reduce discomfort.
• Eating plenty of fruits and vegetables is recommended as they are rich in vitamins and minerals which promote healing and provide essential energy for recovery.
• Soups, stews, casseroles, and other dishes that require minimal chewing can be good options as well.
• It's crucial to drink enough of fluids when recovering from a ruptured spleen to avoid becoming dehydrated.

• Avoid high-fat and fried foods: These types of foods can be hard to digest and may increase the risk of abdominal pain and discomfort.
• Limit alcohol consumption: Drinking alcohol may induce pain in the abdominal region because it irritates the lining of the stomach.
• Avoid spicy foods: Spicy meals have the potential to irritate the digestive system, which may therefore result in abdominal discomfort.
• Limit caffeine intake: Caffeine can cause stomach irritation, which may worsen the symptoms of a ruptured spleen.
• Avoid dairy products: Dairy products, such as milk, ice cream, and cheese, can cause abdominal discomfort in some people with a ruptured spleen.

• Splenectomy: This is a surgical procedure that involves the removal of the spleen. It is the most common treatment for a ruptured spleen.
• Spleen Repair: This surgical procedure involves repairing the damaged spleen with suturing and/or other techniques, such as patching or stitching. The goal of this procedure is to restore normal functioning of the spleen.
• Splenorrhaphy: This surgery involves closing the opening in the spleen using sutures and/or other techniques such as patching or stitching. It is used to treat localized areas of injury, such as a laceration or tear, in the spleen.
• Embolization: This procedure involves blocking off blood vessels that are supplying blood to a ruptured spleen with a small coil or plug in order to stop bleeding and reduce swelling and pain.

You should consult a general surgeon who specialises in abdominal surgery.

You could also consult a gastrologist for a ruptured spleen.

• Non-steroidal anti-inflammatory drugs (NSAIDs): They are often used to relieve the pain and inflammation that come along with a spleen that has burst.
• Examples include ibuprofen, naproxen, and celecoxib.
• Corticosteroids: These drugs reduce inflammation in the body and can help limit the damage to the spleen caused by a rupture. Examples include prednisone and methylprednisolone.
• Antibiotics: These are used to prevent and treat any bacterial infections that may develop after a spleen rupture or during surgery to repair the spleen. Examples include amoxicillin, cefazolin, and clindamycin.
• Anti-coagulants: These medications help prevent blood clots from forming in the affected area, which can further damage the spleen or cause other complications. Examples include heparin and warfarin.
• Pain relievers: Medications such as codeine and oxycodone may be prescribed to help manage pain associated with a ruptured spleen.

• The amount of time it takes to recover from a ruptured spleen depends on the severity of the injury, whether the spleen was removed and other factors. Generally, recovery can take anywhere from two to six weeks.
• The person may need to take it easy and minimise their physical activities during this period.They may also need to take medications to reduce pain and inflammation. Surgery could be required in certain circumstances to fix or remove the spleen.
• People are often advised to stay away from contact sports and other activities where trauma or abdominal harm might happen after recuperating from a burst spleen. They must adhere to their doctor's recommendations and make all necessary follow-up appointments.

No, the results of treatment for a ruptured spleen are not permanent. The spleen may need to be removed, which will permanently alter the body's immune system. n

Surgery may be required to repair the damaged spleen, but it is possible for the spleen to rupture again if it is not monitored and cared for properly.

• Rest and reduce physical activity: After a ruptured spleen, it is important to rest and reduce physical activities for at least four weeks. This helps the body heal and prevent further injury.
• Take medications: Pain relief medications are usually prescribed to help manage symptoms from a ruptured spleen. Antibiotics may also be prescribed to help prevent infection.
• Follow up with your doctor: The best way to monitor your recovery and ensure that there are no consequences or recurrences of the injury is to schedule regular follow-up consultations with your doctor.
• Avoid contact sports: To prevent further injury, contact sports such as football and martial arts should be avoided for at least six months after a ruptured spleen.
• Make dietary changes: Eating a diet high in fibre and low in carbohydrates can help reduce the risk of developing complications from a ruptured spleen, such as constipation or nausea.

Depending on the extent of the damage, the kind of therapy necessary, and the particular hospital or clinic delivering the treatment, the cost of a ruptured spleen treatment in India might vary significantly.n

Generally, a simple spleen repair surgery can range anywhere from around Rs. 50,000 to Rs. 1 lakh, while more complicated surgeries such as splenorrhaphy or splenectomy may cost upwards of Rs. 2-3 lakhs.n

Additionally, post-operative care and medications can add to this total cost.

• Internal bleeding: Ruptured spleen treatment typically involves the surgical removal of the spleen (splenectomy). Without a functioning spleen, patients are at risk for developing internal bleeding and infection.
• Infection: In addition to the risk of infection from the surgery itself, patients may be more prone to infection due to the lack of a functioning spleen. The spleen normally helps to filter out bacteria and other organisms that can cause disease.
• Iron deficiency: Patients who have had a splenectomy may develop anaemia due to iron deficiency, as the spleen helps to recycle iron from old, damaged red blood cells.
• Pain or discomfort: Patients who have undergone splenectomy may experience pain or discomfort in their abdomen due to scarring or adhesions (bands of tissue) that form around the area where the spleen was located.

When the spleen sustains stress, often from car accidents or sports injuries, it might burst. Malaria and other illnesses like mononucleosis are also potential causes. A burst spleen is a medical emergency because it may result in catastrophic internal bleeding. Depending on the severity of the damage, a burst spleen may need surgical removal or, if the danger of surgery is too great, monitoring with intravenous fluids and antibiotics.