Overview

A ruptured spleen is a medical emergency that occurs when your spleen develops a break in its surface. Your spleen, located just under your rib cage on your left side, helps your body fight infection and filter old blood cells from your bloodstream.

A ruptured spleen is generally caused by a forceful blow to your abdomen — during a sporting mishap, a fistfight or a car crash, for example. Without emergency treatment, a ruptured spleen can cause life-threatening internal bleeding.

Some people with ruptured spleens need emergency surgery. Others can be treated with several days of hospital care.

Symptoms

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, particularly if you also have cuts and bruises on the left chest or side
  • 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.

Causes

A spleen may 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 may rupture soon after the abdominal trauma or, in some cases, days or even 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.

Complications

A ruptured spleen can cause life-threatening bleeding into your abdominal cavity.

Prevention

If you've been diagnosed with an enlarged spleen, ask your doctor whether you need to avoid activities that could cause a ruptured spleen. For instance, people with mononucleosis — a viral infection that can cause an enlarged spleen — may be asked to avoid contact sports, heavy lifting 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.