Spleen injuries (1121)
Key points below
What is the spleen?
The spleen is an organ in the upper left part of the stomach (abdomen). It helps the body to fight infections. It also helps the body get rid of old blood cells.Some people live without a spleen. People without spleens often have a hard time fighting infection. They must take medicines and have immunizations to help prevent infections.What is a spleen injury?
A spleen injury could be simple bruises or small tears. In some cases, the spleen is torn into many pieces.What causes spleen injuries?
The most common causes of spleen injuries are from car crashes, fall or sports injuries.
If you think your child has a spleen injury, they should be checked immediately. Spleen injuries can be life-threatening.
What are symptoms?
- Pain in the left upper abdomen.
- Left shoulder pain.
- Dizziness or lightheadedness.
- Nausea and vomiting.
- Weak or fast pulse.
How are they diagnosed?
- A CT scan is done to diagnose a spleen injury. The scan will show how badly the spleen is injured. If an injury is found, your child will be admitted to the hospital.
- The injury is given a grade. The grade is based on how bad the injury is. Grade 1 is the least injured and grade 5 is the most severe. This grade helps us decide how long your child will:
– be on bed rest.
– have activities limited.
|
Grade |
Description of injury |
Nights of bed rest |
Weeks of restricted activity |
|
1 |
Small tear or bruise on the surface of the spleen |
1 |
3 |
|
2 |
Tear in the spleen, less than 3cm deep |
1 |
4 |
|
3 |
A deep tear in the spleen, greater than 3 cm |
2 |
5 |
|
4 |
Multiple tears or a crush injury |
2 |
6 |
|
5 |
Shattered spleen |
2 |
7 |
How are the injuries treated?
- Most spleen injuries heal without surgery. Being on bed rest in the hospital will help your child’s spleen heal.
- Your child should not take part in rough activities for several weeks until the spleen is fully healed. If the spleen is not healed, rough activities may cause more injury or bleeding.
- Spleen injuries need to be monitored closely because the spleen has a large blood supply. This large blood supply increases your child’s risk of heavy bleeding. Your child will have regular blood tests to make sure the bleeding has stopped. When the blood tests show that there is no internal bleeding, the tests will be stopped.
- If a spleen does not heal, it can be an emergency because of bleeding. If this occurs, the spleen is normally removed.
- When your child is admitted to the hospital, a CT scan of the abdomen will be done. This scan will show how badly your child’s spleen is injured.
- Spleen injuries can be painful. Your child may need pain medicine. They will also need a stool softener to keep their bowels moving.
- During restricted activity, your child may go to school, read books, do light chores, go for walks, or swim if well-supervised. Your child may not do any sports; go to recess or gym class. They should not do any rough activities that may re-injure the spleen.
What follow up care is needed?
Your child will need to be seen in the Surgery Clinic after the weeks of restricted activity is done. At this time if the signs and symptoms from the spleen injury are gone, your child will be able to go back to all activities.