Diagnosis

Tests and procedures used to diagnose a ruptured spleen include:

  • Physical exam. Your doctor 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. Your doctor might either use an ultrasound or draw a sample of fluid from your abdomen with a needle. If the sample reveals blood in your abdomen, you might be referred for emergency treatment.
  • Imaging tests of your abdomen. If your diagnosis isn't clear, your doctor might recommend an abdominal CT scan, 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 severity of your condition. Some people require immediate surgery. Others heal with rest and time.

Hospitalization while the spleen heals

Many small or moderate-sized injuries to the spleen can heal without surgery. You're likely to stay in the hospital while doctors 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 to repair or remove the spleen

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 (splenectomy). If it's necessary to remove your spleen, you'll be at increased risk of serious infections, such as sepsis. Risk of sepsis is highest in young children, especially the first two years after the spleen has been removed.

    Your doctor might recommend ways to reduce the risk of infection, such as vaccinations against pneumonia and influenza.

  • 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.

May 07, 2019
References
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  4. Hoffman R, et al. Infectious mononucleosis and other Epstein-Barr virus-associated diseases. In: Hematology: Basic Principles and Practice. 7th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed April 12, 2019.
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