The spleen is located just under your rib cage on your left side. A ruptured spleen may pour a large amount of blood into the abdominal cavity.
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 abdomen — during a sporting mishap, 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.
Signs and symptoms of a ruptured spleen include:
- Pain in the upper left abdomen
- Tenderness when you touch the upper left abdomen
- 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 you may have a ruptured spleen.
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 abdomen or the left lower chest, such as might happen during sporting mishaps, fistfights and car crashes. An injured spleen can rupture soon after the abdominal 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.
A ruptured spleen can cause life-threatening bleeding into your abdominal cavity.
If you've been diagnosed with an enlarged spleen, ask your doctor 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 abdominal trauma.
May 07, 2019
- AskMayoExpert. Splenic injury. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
- Maung AA, et al. Management of splenic injury in the adult trauma patient. https://www.uptodate.com/contents/search. Accessed April 12, 2019.
- Dragomir M, et al. Patients after splenectomy: Old risks and new perspectives. Chirurgia. 2016;111:393.
- 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.
- Liu J, et al. Diagnosis and treatment of atraumatic splenic rupture: Experience of 8 cases. Gastroenterology Research and Practice. 2019;2019:1. https://doi.org/10.1155/2019/5827694. Accessed April 12, 2019.
- Doherty GM, ed. Spleen. In: Current Diagnosis & Treatment: Surgery. 14th ed. New York, N.Y.:McGraw-Hill Education; 2015. https://accessmedicine.mhmedical.com. Accessed April 16, 2019.
- Diercks DB, et al. Initial evaluation and management of blunt abdominal trauma in adults. https://www.uptodate.com/contents/search. Accessed April 12, 2019.