Medical expert of the article
New publications
Ruptured spleen
Last reviewed: 07.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
A ruptured spleen usually results from blunt abdominal trauma.
Enlargement of the spleen due to fulminant infection with the Epstein-Barr virus (infectious mononucleosis or posttransplant pseudolymphoma) predisposes to rupture from minimal trauma or even spontaneous rupture. A significant blow (eg, a car accident) can rupture even a normal spleen.
[ Symptoms of a ruptured spleen
Rupture of the splenic capsule results in significant bleeding into the abdominal cavity. Common clinical manifestations include hemorrhagic shock, abdominal pain, and distension. Trauma to the spleen can result in a subcapsular hematoma, which may not rupture for hours or even months after the injury.
Rupture is usually preceded by upper left quadrant pain. Splenic rupture should be suspected in patients with blunt abdominal trauma and hemorrhagic shock or upper left quadrant pain (which sometimes radiates to the shoulder); patients with unexplained upper left quadrant pain, particularly if there is evidence of hypovolemic shock, should be asked about previous trauma. Diagnosis is confirmed by CT scanning (in stable patients), ultrasound, or peritoneal lavage (in unstable patients).
Where does it hurt?
What do need to examine?
How to examine?
Who to contact?
Treatment of ruptured spleen
Treatment of splenic rupture traditionally consists of splenectomy. However, splenectomy should be avoided whenever possible, particularly in children because of the persistent increased susceptibility to bacterial infections later in life. In these cases, transfusion therapy is necessary.