Materiały źródłowe

• #1 Ruptured Spleen: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17953-ruptured-spleen

  A ruptured spleen is a medical emergency. It can cause life-threatening internal bleeding. […] A ruptured spleen is a medical emergency that requires swift diagnosis and intervention, and sometimes surgery. […] If you have severe upper left abdominal pain or Kehrs sign, even if it occurs sometime after your original injury, you should go straight to the emergency room. […] If your condition is stable but your healthcare team suspects a splenic injury, they will often proceed with a CT scan to get a better look at your spleen and the extent of the injury. […] Treatment depends on the extent of your injury. Some minor tears might stop bleeding on their own, while others may require various types of emergency repairs. […] The outcome depends on how severe your injury is and how quickly it gets diagnosed and treated. […] If you suspect any injury to your spleen, seek medical attention right away to check it for bleeding.

• #2 Ruptured spleen – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/symptoms-causes/syc-20352317

  Ruptured spleen is a medical emergency that occurs as a result of a break in your spleen’s surface. […] A ruptured spleen is a medical emergency. Seek emergency care after an injury if your signs and symptoms indicate that you may have a ruptured spleen. […] A ruptured spleen can cause life-threatening bleeding into your stomach cavity. […] If you’ve been diagnosed with an enlarged spleen, ask your health care provider whether you need to avoid activities for several weeks that could cause it to rupture.

• #3 Ruptured spleen (ruptured spleen) – USZ

  https://www.usz.ch/en/disease/ruptured-spleen/

  A ruptured spleen is an emergency in which doctors must act quickly! This is because life-threatening bleeding can occur in the abdomen, which must be stopped quickly. […] A ruptured spleen is always an emergency in which doctors must act quickly. This is because bleeding may occur in the abdomen, which can be life-threatening. […] The diagnosis of a ruptured spleen should always be made as quickly as possible, because a ruptured spleen is an emergency! Bleeding into the abdominal cavity is life-threatening. We have to treat the ruptured spleen immediately and stop the bleeding. […] A ruptured spleen is always an emergency. Doctors must treat this immediately to avoid life-threatening consequences.

• #4 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #5 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  How Is a Ruptured Spleen Diagnosed? […] The doctor will do a physical exam and ask about the patient’s medical history and feel their belly area. The abdominal area may feel hard and look swollen (distended) because it has filled with blood. If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed. […] Imaging tests are needed to diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on the CT scan without contrast.

• #6 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  How Is a Ruptured Spleen Diagnosed? […] The doctor will do a physical exam and ask about the patient’s medical history and feel their belly area. The abdominal area may feel hard and look swollen (distended) because it has filled with blood. If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed. […] Imaging tests are needed to diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on the CT scan without contrast.

• #7 Ruptured Spleen: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17953-ruptured-spleen

  A ruptured spleen is a medical emergency. It can cause life-threatening internal bleeding. […] A ruptured spleen is a medical emergency that requires swift diagnosis and intervention, and sometimes surgery. […] If you have severe upper left abdominal pain or Kehrs sign, even if it occurs sometime after your original injury, you should go straight to the emergency room. […] If your condition is stable but your healthcare team suspects a splenic injury, they will often proceed with a CT scan to get a better look at your spleen and the extent of the injury. […] Treatment depends on the extent of your injury. Some minor tears might stop bleeding on their own, while others may require various types of emergency repairs. […] The outcome depends on how severe your injury is and how quickly it gets diagnosed and treated. […] If you suspect any injury to your spleen, seek medical attention right away to check it for bleeding.

• #8 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  The spleen is the visceral organ most frequently injured in blunt abdominal trauma. Trauma is also the most common cause of a ruptured spleen. […] This activity reviews the evaluation and management of patients with splenic rupture and highlights the role of the interprofessional team in the management of patients with this condition. […] Explain how to evaluate a patient for splenic rupture. […] Evaluation for splenic injury is therefore warranted if left lower rib fractures are identified. Up to 20% of adults with left lower rib fractures may have a subsequent splenic injury. […] A splenic injury may not always be clinically apparent, and spontaneous splenic rupture or pathologic splenic rupture can occur after negligible trauma or insignificant events. […] Ultrasound can be very helpful and highly accurate in the diagnosis of significant splenic injury but is limited in detecting active bleeding, pseudoaneurysm, or early in the evaluation when blood loss is minimal.

• #9 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  How Is a Ruptured Spleen Diagnosed? […] The doctor will do a physical exam and ask about the patient’s medical history and feel their belly area. The abdominal area may feel hard and look swollen (distended) because it has filled with blood. If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed. […] Imaging tests are needed to diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on the CT scan without contrast.

• #10 Splenic Rupture: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/432823-overview

  Although protected under the bony ribcage, the spleen remains the most commonly affected organ in blunt injury to the abdomen in all age groups. […] A thorough knowledge of splenic function, anatomy, and pathophysiology is necessary to continue the progress of the last decade and to decrease the mortality rate from this common injury in the United States and worldwide. […] The clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of left upper quadrant abdominal tenderness. […] In simple terms, unstable patients suspected of splenic injury and intra-abdominal hemorrhage should undergo exploratory laparotomy and splenic repair or removal. […] The major determining factors in operative intervention in the stable patient with a splenic injury include grade of injury (American Association for the Surgery of Trauma [AAST] scale), presence of intraperitoneal blood, presence of a blush on CT scan, calculated risk of rebleeding, presence and severity of concomitant injuries, and options regarding blood transfusion. […] Signs of persistent bleeding and hemodynamic instability unresponsive to fluid and blood administration are clear indications for surgery.

• #11 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  While frequently obtained, a complete blood cell count or hemoglobin level is rarely helpful in the initial workup of the suspected splenic injury. These are helpful in providing baseline values and, when performed serially, in diagnosing ongoing blood loss or hemodilution due to volume resuscitation. […] Focused abdominal sonographic technique (FAST), observing for the presence or absence of fluid in the peritoneal cavity, may be performed rapidly and safely in trauma patients. […] In experienced hands, visualization of fluid in the right upper quadrant, the left upper quadrant, and the pelvis suggests solid organ injury (or mesenteric injury) and the possibility of splenic injury. […] In the stable patient, CT scanning provides structural evaluation of the spleen and surrounding organs.

• #12 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  However, a CT scan of the abdomen may only be done if time allows. A CT scan with contrast may take a while, and some people with spleen ruptures have died while waiting to have the test done. For this reason, a CT scan is not recommended for those with a spleen rupture who have unstable vital signs or low blood pressure due to the injury (suggesting shock). They would have a quick ultrasound, and then go straight to surgery if bleeding is detected. […] In these cases, other tests may be used to help diagnose a spleen rupture. They include: […] Focused abdominal sonographic technique (FAST). This is an ultrasound method to check for blood in the abdominal area. It can be used to help diagnose a ruptured spleen in unstable patients, but studies have found CT to be better in an emergency setting.

• #13 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  While frequently obtained, a complete blood cell count or hemoglobin level is rarely helpful in the initial workup of the suspected splenic injury. These are helpful in providing baseline values and, when performed serially, in diagnosing ongoing blood loss or hemodilution due to volume resuscitation. […] Focused abdominal sonographic technique (FAST), observing for the presence or absence of fluid in the peritoneal cavity, may be performed rapidly and safely in trauma patients. […] In experienced hands, visualization of fluid in the right upper quadrant, the left upper quadrant, and the pelvis suggests solid organ injury (or mesenteric injury) and the possibility of splenic injury. […] In the stable patient, CT scanning provides structural evaluation of the spleen and surrounding organs.

• #14 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  How do doctors diagnose a ruptured spleen? […] Before diagnosing a ruptured spleen, a doctor will first consider your injuries and symptoms. If your symptoms suggest a high likelihood of splenic rupture, they may order imaging tests. […] Some imaging techniques can help a doctor view your spleen more clearly to confirm a diagnosis. These include: […] Focused assessment with sonography for trauma (FAST): A FAST examination involves using ultrasound on key areas of your chest and abdomen to identify blood around the spleen. The presence of blood would suggest a rupture. But doctors cant identify all aspects of splenic injury with this quick, bedside examination. […] CT scan: A CT scan allows a doctor to identify injuries to the spleen and other surrounding organs. […] While CT scans can be more sensitive to detecting splenic injuries, it can take a long time to obtain a CT scan. If you have symptoms of severe injury and bleeding, your doctor will usually recommend rapid, lifesaving interventions, since a ruptured spleen is a medical emergency.

• #15 Diagnosis and Treatment of Atraumatic Splenic Rupture: Experience of 8 Cases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6369493/

  Atraumatic splenic rupture (ASR) is rare but life threatening. […] The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. […] ASR is often life threatening due to the delay of diagnosis and treatment. […] There is still a lack of related guidelines or a standard of diagnosis and treatment for ASR. […] In this study, we showed that the incidence of ASR was 3.2% (8/251). […] The mortality of ASR is 12.2%-20%. […] The mortality of ASR was 0 in this study, which was potentially attributed to our timely diagnosis and appropriate management. […] In this series, at least 5 patients (62.5%) with 7 etiological factors belonged to atraumatic-pathological splenic rupture. […] In this study, the sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in diagnosing ASR was 57.1% (4/7) and 85.7% (6/7), respectively.

• #16 Ruptured spleen: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/192110

  Doctors diagnose a ruptured spleen by examining the abdomen and using either an ultrasound or CT scan, depending on the condition of the individual. […] Internal bleeding is confirmed by low blood pressure, a high heart rate, and a positive FAST ultrasound scan. If these results indicate splenic rupture, urgent abdominal surgery is needed to determine the source of the bleeding. […] An ultrasound scan is the most sensitive diagnostic method for injuries to the abdomen, although a normal scan may not rule out splenic rupture. […] A doctor who has reason to suspect a ruptured spleen will first examine the abdomen to look for tenderness or enlargement as a result of fluid buildup, usually blood. […] In people who are hemodynamically stable, a CT scan is typically used to help determine the grade of injury. […] The grading of a ruptured spleen helps doctors determine whether surgical or non-operative management is indicated for treatment.

• #17 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #18 Ruptured Spleen: Symptoms, Causes, and How It’s Treated

  https://www.verywellhealth.com/ruptured-spleen-overview-4584827

  Diagnosing a ruptured spleen may include: […] A CT scan is the best option for evaluating the abdomen and diagnosing a ruptured spleen. CT scans can detect as little as 100 cubic centimeters of blood in the abdomen, an amount similar to about one-third of a can of soda. […] Getting an early diagnosis is important, regardless of whether the treatment will require surgery or not.

• #19 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  While frequently obtained, a complete blood cell count or hemoglobin level is rarely helpful in the initial workup of the suspected splenic injury. These are helpful in providing baseline values and, when performed serially, in diagnosing ongoing blood loss or hemodilution due to volume resuscitation. […] Focused abdominal sonographic technique (FAST), observing for the presence or absence of fluid in the peritoneal cavity, may be performed rapidly and safely in trauma patients. […] In experienced hands, visualization of fluid in the right upper quadrant, the left upper quadrant, and the pelvis suggests solid organ injury (or mesenteric injury) and the possibility of splenic injury. […] In the stable patient, CT scanning provides structural evaluation of the spleen and surrounding organs.

• #20 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #21 Ruptured Spleen: Symptoms, Causes, and How It’s Treated

  https://www.verywellhealth.com/ruptured-spleen-overview-4584827

  Diagnosing a ruptured spleen may include: […] A CT scan is the best option for evaluating the abdomen and diagnosing a ruptured spleen. CT scans can detect as little as 100 cubic centimeters of blood in the abdomen, an amount similar to about one-third of a can of soda. […] Getting an early diagnosis is important, regardless of whether the treatment will require surgery or not.

• #22 Diagnosis and Treatment of Atraumatic Splenic Rupture: Experience of 8 Cases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6369493/

  Atraumatic splenic rupture (ASR) is rare but life threatening. […] The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. […] ASR is often life threatening due to the delay of diagnosis and treatment. […] There is still a lack of related guidelines or a standard of diagnosis and treatment for ASR. […] In this study, we showed that the incidence of ASR was 3.2% (8/251). […] The mortality of ASR is 12.2%-20%. […] The mortality of ASR was 0 in this study, which was potentially attributed to our timely diagnosis and appropriate management. […] In this series, at least 5 patients (62.5%) with 7 etiological factors belonged to atraumatic-pathological splenic rupture. […] In this study, the sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in diagnosing ASR was 57.1% (4/7) and 85.7% (6/7), respectively.

• #23 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #24 Ruptured spleen: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/192110

  Doctors diagnose a ruptured spleen by examining the abdomen and using either an ultrasound or CT scan, depending on the condition of the individual. […] Internal bleeding is confirmed by low blood pressure, a high heart rate, and a positive FAST ultrasound scan. If these results indicate splenic rupture, urgent abdominal surgery is needed to determine the source of the bleeding. […] An ultrasound scan is the most sensitive diagnostic method for injuries to the abdomen, although a normal scan may not rule out splenic rupture. […] A doctor who has reason to suspect a ruptured spleen will first examine the abdomen to look for tenderness or enlargement as a result of fluid buildup, usually blood. […] In people who are hemodynamically stable, a CT scan is typically used to help determine the grade of injury. […] The grading of a ruptured spleen helps doctors determine whether surgical or non-operative management is indicated for treatment.

• #25 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  However, a CT scan of the abdomen may only be done if time allows. A CT scan with contrast may take a while, and some people with spleen ruptures have died while waiting to have the test done. For this reason, a CT scan is not recommended for those with a spleen rupture who have unstable vital signs or low blood pressure due to the injury (suggesting shock). They would have a quick ultrasound, and then go straight to surgery if bleeding is detected. […] In these cases, other tests may be used to help diagnose a spleen rupture. They include: […] Focused abdominal sonographic technique (FAST). This is an ultrasound method to check for blood in the abdominal area. It can be used to help diagnose a ruptured spleen in unstable patients, but studies have found CT to be better in an emergency setting.

• #26 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  How do doctors diagnose a ruptured spleen? […] Before diagnosing a ruptured spleen, a doctor will first consider your injuries and symptoms. If your symptoms suggest a high likelihood of splenic rupture, they may order imaging tests. […] Some imaging techniques can help a doctor view your spleen more clearly to confirm a diagnosis. These include: […] Focused assessment with sonography for trauma (FAST): A FAST examination involves using ultrasound on key areas of your chest and abdomen to identify blood around the spleen. The presence of blood would suggest a rupture. But doctors cant identify all aspects of splenic injury with this quick, bedside examination. […] CT scan: A CT scan allows a doctor to identify injuries to the spleen and other surrounding organs. […] While CT scans can be more sensitive to detecting splenic injuries, it can take a long time to obtain a CT scan. If you have symptoms of severe injury and bleeding, your doctor will usually recommend rapid, lifesaving interventions, since a ruptured spleen is a medical emergency.

• #27 Spleen problems and spleen removal

  https://www.nhs.uk/conditions/spleen-problems-and-spleen-removal/

  The spleen can become damaged or may burst (rupture) after an injury, such as a blow to the abdomen, a car accident, a sporting accident or broken ribs. […] Signs of a ruptured spleen are: pain behind your left ribs and tenderness when you touch this area. […] A ruptured spleen is a medical emergency, as it can cause life-threatening bleeding. […] Doctors can often tell if you have an enlarged spleen by feeling your abdomen. A blood test, CT scan or MRI scan can confirm the diagnosis. […] You may need an operation to remove your spleen, known as a splenectomy, if it’s not working properly or it’s damaged, diseased or enlarged. […] Recovery usually takes a few weeks. Your doctor or nurse will advise when you can go back to your usual activities, such as driving.

• #28 Enlarged Spleen (Splenomegaly): Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17829-enlarged-spleen

  An enlarged spleen is a symptom of many different conditions, some more serious than others. […] If an enlarged spleen goes untreated for a long time, it could eventually begin to malfunction. In rare cases, a severely enlarged spleen could rupture, which could cause internal bleeding. […] An enlarged spleen may in rare cases spontaneously rupture or may rupture due to a direct impact, such as a blow or a fall. A ruptured spleen can be life-threatening. […] You might come to your healthcare provider with symptoms of vague abdominal discomfort, or you might have symptoms related to your underlying condition. […] Your provider will likely be able to feel your enlarged spleen during a physical exam. It can also show up in imaging. […] You may have various medical tests to confirm an enlarged spleen and help isolate the cause, including: Imaging tests. An abdominal ultrasound or CT scan can help confirm an enlarged spleen and may give additional information, such as how severe it is, whether it has a lesion or whether it is encroaching on any other organs. […] If you notice increased pain in the area of your spleen or your left shoulder, especially if it’s worse when you breathe in, seek medical attention right away. A rupture is more likely to happen after an impact to your abdomen, but sometimes it happens by itself.

• #29 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #30 Scintigraphy in the diagnosis of splenic rupture (Journal Article) | ETDEWEB

  https://www.osti.gov/etdeweb/biblio/7224255

  The diagnosis of rupture of the spleen may be notoriously difficult, e.g., in the multiple injury patient, the comatose patient or the intoxicated patient, as well as in subcapsular hematoma, and in smaller ruptures which have temporarily ceased bleeding. […] Scintiscanning provides a most valuable diagnostic tool when using technetium 99m sulphur colloid, which is taken up by the cells in the reticulo-endothelial system. […] It is easy, quick, non-invasive, and most reliable. […] The radiation dose is less than that given by abdominal angiography and it is also less expensive.

• #31 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  While frequently obtained, a complete blood cell count or hemoglobin level is rarely helpful in the initial workup of the suspected splenic injury. These are helpful in providing baseline values and, when performed serially, in diagnosing ongoing blood loss or hemodilution due to volume resuscitation. […] Focused abdominal sonographic technique (FAST), observing for the presence or absence of fluid in the peritoneal cavity, may be performed rapidly and safely in trauma patients. […] In experienced hands, visualization of fluid in the right upper quadrant, the left upper quadrant, and the pelvis suggests solid organ injury (or mesenteric injury) and the possibility of splenic injury. […] In the stable patient, CT scanning provides structural evaluation of the spleen and surrounding organs.

• #32 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #33 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #34 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  Diagnostic peritoneal lavage. This is a method to rapidly determine if blood is gathering in the abdominal area. During a DPL, a needle connected to a catheter is inserted into your abdominal cavity to see if there is blood is accumulating. It is fast and inexpensive and can be done on spleen rupture patients who have low blood pressure. […] If the person is stable and does not need emergency surgery, laboratory tests such as a complete blood count (CBC) or hemoglobin level may be done at routine intervals to check for blood loss.

• #35 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  continuing to measure your vital signs to ensure youre stable […] ordering repeat imaging […] checking your blood counts frequently to ensure you arent experiencing further bleeding. […] What are the possible complications of a ruptured spleen? […] The main complication of a ruptured spleen is excessive bleeding. Blood loss from a ruptured spleen can be so significant that it results in death without treatment. […] If you experience an accident that results in symptoms of a ruptured spleen, get help immediately. A delay in treatment could lead to more serious complications or death.

• #36 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  While frequently obtained, a complete blood cell count or hemoglobin level is rarely helpful in the initial workup of the suspected splenic injury. These are helpful in providing baseline values and, when performed serially, in diagnosing ongoing blood loss or hemodilution due to volume resuscitation. […] Focused abdominal sonographic technique (FAST), observing for the presence or absence of fluid in the peritoneal cavity, may be performed rapidly and safely in trauma patients. […] In experienced hands, visualization of fluid in the right upper quadrant, the left upper quadrant, and the pelvis suggests solid organ injury (or mesenteric injury) and the possibility of splenic injury. […] In the stable patient, CT scanning provides structural evaluation of the spleen and surrounding organs.

• #37 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #38 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  Diagnostic peritoneal lavage. This is a method to rapidly determine if blood is gathering in the abdominal area. During a DPL, a needle connected to a catheter is inserted into your abdominal cavity to see if there is blood is accumulating. It is fast and inexpensive and can be done on spleen rupture patients who have low blood pressure. […] If the person is stable and does not need emergency surgery, laboratory tests such as a complete blood count (CBC) or hemoglobin level may be done at routine intervals to check for blood loss.

• #39 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  Diagnostic peritoneal lavage. This is a method to rapidly determine if blood is gathering in the abdominal area. During a DPL, a needle connected to a catheter is inserted into your abdominal cavity to see if there is blood is accumulating. It is fast and inexpensive and can be done on spleen rupture patients who have low blood pressure. […] If the person is stable and does not need emergency surgery, laboratory tests such as a complete blood count (CBC) or hemoglobin level may be done at routine intervals to check for blood loss.

• #40 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  Diagnostic peritoneal lavage. This is a method to rapidly determine if blood is gathering in the abdominal area. During a DPL, a needle connected to a catheter is inserted into your abdominal cavity to see if there is blood is accumulating. It is fast and inexpensive and can be done on spleen rupture patients who have low blood pressure. […] If the person is stable and does not need emergency surgery, laboratory tests such as a complete blood count (CBC) or hemoglobin level may be done at routine intervals to check for blood loss.

• #41 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #42 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #43 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #44 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #45 Ruptured spleen: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/192110

  Doctors diagnose a ruptured spleen by examining the abdomen and using either an ultrasound or CT scan, depending on the condition of the individual. […] Internal bleeding is confirmed by low blood pressure, a high heart rate, and a positive FAST ultrasound scan. If these results indicate splenic rupture, urgent abdominal surgery is needed to determine the source of the bleeding. […] An ultrasound scan is the most sensitive diagnostic method for injuries to the abdomen, although a normal scan may not rule out splenic rupture. […] A doctor who has reason to suspect a ruptured spleen will first examine the abdomen to look for tenderness or enlargement as a result of fluid buildup, usually blood. […] In people who are hemodynamically stable, a CT scan is typically used to help determine the grade of injury. […] The grading of a ruptured spleen helps doctors determine whether surgical or non-operative management is indicated for treatment.

• #46 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #47 Imaging findings of splenic emergencies: a pictorial review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-016-0467-8

  Although traumatic injuries are the cause of common splenic emergencies in the emergency room, various nontraumatic conditions may also affect the spleen with possible life-threatening results. […] It is essential to be familiar with key imaging findings and advantages of different modalities to reach a definitive diagnosis. […] Delayed splenic rupture is commonly related to subcapsular hematoma. […] The whorled appearance is the key imaging feature of splenic torsion. […] Therefore, computed tomography (CT) is the main modality used in the assessment of splenic emergencies. […] In clinical practice, the spleen is relatively underrated in the setting of acute abdomen. However, late diagnosed splenic emergencies may result in mortality. […] CT may demonstrate laceration, hypoperfusion, subcapsular / parenchymal hematoma, active bleeding and pseudoaneurysms in a splenic injury.

• #48 Splenic Infarct – TeachMeSurgery

  https://teachmesurgery.com/hpb/spleen/splenic-infarct/

  A splenic infarct is caused by occlusion of the splenic artery or one of its branches, resulting in tissue necrosis. They are be caused by a variety of potential pathologies, however fortunately splenic infarctions are rare events. […] The gold standard investigation for suspected splenic infarction is a CT abdominal scan with IV contrast. […] Routine bloods, including FBC, UEs, LFTs, and coagulation screen, will aid diagnosis, especially if a haematological or thromboembolic cause is suspected. […] Diagnosis may be based on CT scanning viewed by an experienced radiologist, especially when combined with raised inflammatory markers, however most cases will only be confirmed with explorative surgery. […] There are no specific treatments for splenic infarct. Patients are monitored regularly, ensuring haemodynamic stability, with appropriate analgesia and IV hydration prescribed.

• #49 Imaging findings of splenic emergencies: a pictorial review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-016-0467-8

  Active haemorrhage can be demonstrated by contrast-enhanced CT as an extravasation of intravenously introduced contrast material to the abdominal cavity. […] In subtle extravasation, haemorrhage is commonly restricted to the site of solid organ injury, with the appearance of what is called the sentinel clot sign. […] The whorled appearance of splenic vascular pedicle on cross-sectional images is a reliable sign of torsion. […] Splenectomy is required in most cases, since patients commonly present with splenic infarction or haemorrhage. […] Acute splenic sequestration crisis (ASSC) is a form of hypovolemic and anaemic crisis, based on massive splenic enlargement due to accumulation and trapment of sickle-shaped cells. […] Early diagnosis of ASSC is crucial, since rapid pooling of a large volume of blood may result in splenic rupture, hypovolemic shock and death. […] Awareness of the imaging findings in splenic emergencies assists in establishing the diagnosis of life-threatening conditions.

• #50 Splenic Infarct – TeachMeSurgery

  https://teachmesurgery.com/hpb/spleen/splenic-infarct/

  It is important to identify the cause of the infarction, which may require the involvement of a haematologist and an ECHO scan, as well as consideration of long term anticoagulation. […] The prognosis of splenic infarctions varies enormously, depending on the cause and severity of the disease. […] The most common complications of splenic infarction are splenic rupture, splenic abscess, and pseudocyst formation.

• #51 Spleen Cancer in Dogs | PetMD

  https://www.petmd.com/dog/conditions/cancer/spleen-cancer-dogs

  Veterinarians may suspect a bleeding splenic tumor based on clinical signs and physical exam alone. […] A bleeding or ruptured tumor will often lead to anemia (low red blood cell count) and low platelets, which can be detected by a complete blood count. […] Because low platelets and other factors necessary for clotting are common signs in some types of splenic tumors, coagulation tests will be done to determine if a dog is at risk for severe bleeding issues. […] Radiographs, or x-rays, are useful to determine the overall size, shape, and placement of the spleen in reference to other abdominal organs. […] Ultrasonography allows more detailed analysis of the internal structure, location, and size of the spleen and other abdominal organs. […] Dogs with a ruptured splenic tumor commonly have abnormal fluid accumulation in the abdomen. […] Splenic biopsy can be performed under ultrasound guidance with a large needle to collect a sample of spleen cells, as well as during surgical removal of the spleen.

• #52 Primary Angiosarcoma Of The Spleen With Spontaneous Rupture: A Case Report | SciTechnol

  https://www.scitechnol.com/peer-review/primary-angiosarcoma-of-the-spleen-with-spontaneous-rupture-a-case-report-6cvd.php?article_id=20969

  Primary Splenic Angiosarcoma (PSA), is a rare neoplasm of vascular origin associated with aggressive behavior and poor prognosis. […] The clinical presentation is usually non-specific and is mostly characterized by a wasting disease with anemia and splenomegaly, mimicking a wide range of entities. […] Patients may present with hemoperitoneum secondary to splenic rupture (25%-30%), as well as bleeding from liver metastases. […] Considering these findings, the diagnosis of splenic angiosarcoma with secondary hemoperitoneum is proposed. […] The most severe manifestation is splenic rupture, which often leads to fatal hemorrhage. […] Clinical presentation of splenic angiosarcoma is variable. Left upper abdominal pain is the most common symptom. Splenomegaly is the most common physical examination finding.

• #53 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #54 An unusual diagnosis of splenic rupture | BMJ Case Reports

  https://casereports.bmj.com/content/2014/bcr-2014-204891

  A 22-year-old woman presented with a 3-day history of worsening epigastric pain, non-productive cough and vomiting. On examination she was pale and had abdominal tenderness predominant in the right upper quadrant. Abdominal ultrasound excluded the presence of gall stones, but was unable to rule out free fluid in the abdomen. CT demonstrated extensive high-density ascites; however, no source of bleeding could be demonstrated. Clinically the patient’s condition deteriorated, and an exploratory laparotomy was performed. In theatre the splenic capsule was found to have detached from the splenic body and emergency splenectomy was performed. […] The interesting aspects of this case include the poor correlation between initial presenting symptoms and subsequent diagnosis, the difficulty encountered in making a firm diagnosis and the atypical cause of rupture.

• #55 An unusual diagnosis of splenic rupture | BMJ Case Reports

  https://casereports.bmj.com/content/2014/bcr-2014-204891

  A 22-year-old woman presented with a 3-day history of worsening epigastric pain, non-productive cough and vomiting. On examination she was pale and had abdominal tenderness predominant in the right upper quadrant. Abdominal ultrasound excluded the presence of gall stones, but was unable to rule out free fluid in the abdomen. CT demonstrated extensive high-density ascites; however, no source of bleeding could be demonstrated. Clinically the patient’s condition deteriorated, and an exploratory laparotomy was performed. In theatre the splenic capsule was found to have detached from the splenic body and emergency splenectomy was performed. […] The interesting aspects of this case include the poor correlation between initial presenting symptoms and subsequent diagnosis, the difficulty encountered in making a firm diagnosis and the atypical cause of rupture.

• #56 Imaging findings of splenic emergencies: a pictorial review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-016-0467-8

  Although traumatic injuries are the cause of common splenic emergencies in the emergency room, various nontraumatic conditions may also affect the spleen with possible life-threatening results. […] It is essential to be familiar with key imaging findings and advantages of different modalities to reach a definitive diagnosis. […] Delayed splenic rupture is commonly related to subcapsular hematoma. […] The whorled appearance is the key imaging feature of splenic torsion. […] Therefore, computed tomography (CT) is the main modality used in the assessment of splenic emergencies. […] In clinical practice, the spleen is relatively underrated in the setting of acute abdomen. However, late diagnosed splenic emergencies may result in mortality. […] CT may demonstrate laceration, hypoperfusion, subcapsular / parenchymal hematoma, active bleeding and pseudoaneurysms in a splenic injury.

• #57 Spontaneous splenic rupture | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/spontaneous-splenic-rupture?lang=us

  Spontaneous splenic rupture (SSR) (also known as atraumatic splenic rupture) is rare, especially when compared to traumatic splenic rupture. […] The pathogenesis of atraumatic splenic rupture is not well understood. […] Features are similar to splenic trauma with hemoperitoneum and perisplenic hematoma. The spleen is more likely to be enlarged in atraumatic ruptures.

• #58 Spontaneous Rupture of the Spleen: A Case Report and Review of the Literature

  https://www.ej-med.org/index.php/ejmed/article/view/2147

  Non-traumatic ruptures of the spleen are rare, difficult to diagnose and potentially fatal. […] Mortality in this condition is essentially linked to delays in diagnosis and treatment, as well as to risks associated with the terrain and severity of the underlying pathology. […] Splenic rupture is often overlooked in the differential diagnosis of abdominal pain in the absence of trauma, and in most cases requires splenectomy for treatment. […] The diagnosis of splenic rupture is challenging. It may be revealed by a left upper quadrant pain and hemodynamic instability. […] Radiology is the key to suggesting the diagnosis; ultrasound is the first imaging to demand its low specificity. CT scan is the key test to make the diagnosis and grade the splenic injury. […] Management of SSR primarily depends on the patients hemodynamic stability.

• #59 Non-traumatic splenic rupture – a rare first presentation of diffuse large B-cell lymphoma and a review of the literature | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-018-4702-1

  Cases of non-traumatic splenic rupture are rare and entails a potentially grave medical outcome. Hence, it is important to consider the differential diagnosis of a non-traumatic splenic rupture in patients with acute or insidious abdominal pain. […] The occurrence of true spontaneous splenic rupture is uncommon. In a recent systematic review of 613 cases of splenic rupture, only 84 cases were secondary to hematological malignancy. Acute leukemia and non-Hodgkin lymphoma were the most frequent causes of splenic rupture, followed by chronic and acute myelogeneous leukemias. […] Non-traumatic splenic rupture is a rare clinical presentation with potentially grave medical outcome. Owing to its elusive nature, the recognition of a non-traumatic splenic rupture requires a high index of clinical suspicion.

• #60 Possible infectious causes of spontaneous splenic rupture: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-8-396

  Spontaneous atraumatic splenic rupture is a rare but dramatic occurrence that is most commonly attributed to infection or neoplasia. […] The differential diagnosis for atraumatic splenic rupture, specifically its infectious causes, is reviewed. Key clinical and laboratory findings that differentiate Bartonella henselae infection and EpsteinBarr virus reinfection are reviewed. […] The diagnosis of atraumatic splenic rupture (ASR) can be made with the Orloff and Peskin criteria, which states that ASR can be diagnosed when the following four criteria are met: 1) thorough history reveals no antecedent trauma; 2) no evidence of disease in organs other than the spleen that can cause rupture; 3) no perisplenic adhesions or scarring consistent with trauma or past rupture; and 4) normal spleen on gross and histological examination.

• #61 Spontaneous Rupture of the Spleen: A Case Report and Review of the Literature

  https://www.ej-med.org/index.php/ejmed/article/view/2147

  Non-traumatic ruptures of the spleen are rare, difficult to diagnose and potentially fatal. […] Mortality in this condition is essentially linked to delays in diagnosis and treatment, as well as to risks associated with the terrain and severity of the underlying pathology. […] Splenic rupture is often overlooked in the differential diagnosis of abdominal pain in the absence of trauma, and in most cases requires splenectomy for treatment. […] The diagnosis of splenic rupture is challenging. It may be revealed by a left upper quadrant pain and hemodynamic instability. […] Radiology is the key to suggesting the diagnosis; ultrasound is the first imaging to demand its low specificity. CT scan is the key test to make the diagnosis and grade the splenic injury. […] Management of SSR primarily depends on the patients hemodynamic stability.

• #62 Possible infectious causes of spontaneous splenic rupture: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-8-396

  The causes of ASR are varied and can be classified into seven main categories: neoplastic, infectious, hematological, inflammatory, iatrogenic, primary splenic causes or idiopathic. Proportionally, neoplasia and infection account for more than half of the cases. […] Given that infections explain approximately one-quarter of ASR cases, infectious etiologies should be on the differential when a patient presents with ASR. A detailed history and physical are required to screen for infectious causes although delineating the exact infectious etiology can be challenging with the limitation of serological diagnostics.

• #63 Possible infectious causes of spontaneous splenic rupture: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-8-396

  Spontaneous atraumatic splenic rupture is a rare but dramatic occurrence that is most commonly attributed to infection or neoplasia. […] The differential diagnosis for atraumatic splenic rupture, specifically its infectious causes, is reviewed. Key clinical and laboratory findings that differentiate Bartonella henselae infection and EpsteinBarr virus reinfection are reviewed. […] The diagnosis of atraumatic splenic rupture (ASR) can be made with the Orloff and Peskin criteria, which states that ASR can be diagnosed when the following four criteria are met: 1) thorough history reveals no antecedent trauma; 2) no evidence of disease in organs other than the spleen that can cause rupture; 3) no perisplenic adhesions or scarring consistent with trauma or past rupture; and 4) normal spleen on gross and histological examination.

• #64 The Symptoms and Causes of a Ruptured Spleen – The Thistle Law Firm

  https://thistlelaw.com/the-symptoms-and-causes-of-a-ruptured-spleen/

  A ruptured spleen may present immediately after a traumatic event such as a car accident, but it may sometimes not appear for days or weeks after the trauma. This is a situation known as “delayed splenic rupture”. In one case, a ruptured spleen did not present itself until 4 months after a minor blunt trauma to the abdomen. […] Most ruptured spleens will require immediate surgery called a splenectomy, in which the surgeon will remove the entire spleen. In some cases, the surgeon may be able to repair the tear and put pressure on the spleen until the bleeding has stopped.

• #65 Imaging findings of splenic emergencies: a pictorial review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-016-0467-8

  Although traumatic injuries are the cause of common splenic emergencies in the emergency room, various nontraumatic conditions may also affect the spleen with possible life-threatening results. […] It is essential to be familiar with key imaging findings and advantages of different modalities to reach a definitive diagnosis. […] Delayed splenic rupture is commonly related to subcapsular hematoma. […] The whorled appearance is the key imaging feature of splenic torsion. […] Therefore, computed tomography (CT) is the main modality used in the assessment of splenic emergencies. […] In clinical practice, the spleen is relatively underrated in the setting of acute abdomen. However, late diagnosed splenic emergencies may result in mortality. […] CT may demonstrate laceration, hypoperfusion, subcapsular / parenchymal hematoma, active bleeding and pseudoaneurysms in a splenic injury.

• #66 Imaging findings of splenic emergencies: a pictorial review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-016-0467-8

  Although traumatic injuries are the cause of common splenic emergencies in the emergency room, various nontraumatic conditions may also affect the spleen with possible life-threatening results. […] It is essential to be familiar with key imaging findings and advantages of different modalities to reach a definitive diagnosis. […] Delayed splenic rupture is commonly related to subcapsular hematoma. […] The whorled appearance is the key imaging feature of splenic torsion. […] Therefore, computed tomography (CT) is the main modality used in the assessment of splenic emergencies. […] In clinical practice, the spleen is relatively underrated in the setting of acute abdomen. However, late diagnosed splenic emergencies may result in mortality. […] CT may demonstrate laceration, hypoperfusion, subcapsular / parenchymal hematoma, active bleeding and pseudoaneurysms in a splenic injury.

• #67 Diagnosis and treatment of traumatic delayed rupture of spleen | Chinese Journal of Digestive Surgery;(12): 943-946, 2014. | WPRIM

  https://pesquisa.bvsalud.org/portal/resource/pt/wpr-470203

  Objective To summarize the experiences in the diagnosis and treatment of delayed rupture of spleen. […] B sonography and computed tomography are important methods for the treatment of delayed rupture of spleen. […] Traumatic delayed rupture of spleen should be considered when the patient had symptoms including history of injury of the left hypochondriac region, the course of abdominal pain, abdominal pain alleviation, abdominal pain recurrence, time for abdominal pain alleviation longer than 48 hours, interperitoneal hemorrhage and the signs of splenic rupture indicated by B ultrasonography and computed tomography. […] The indication of spleen-preservation surgery or splenectomy for patients with delayed rupture of spleen should be strictly controlled and optimal surgical procedure should be designed according to the condition of the patient.

• #68 Diagnosis and treatment of traumatic delayed rupture of spleen | Chinese Journal of Digestive Surgery;(12): 943-946, 2014. | WPRIM

  https://pesquisa.bvsalud.org/portal/resource/pt/wpr-470203

  Objective To summarize the experiences in the diagnosis and treatment of delayed rupture of spleen. […] B sonography and computed tomography are important methods for the treatment of delayed rupture of spleen. […] Traumatic delayed rupture of spleen should be considered when the patient had symptoms including history of injury of the left hypochondriac region, the course of abdominal pain, abdominal pain alleviation, abdominal pain recurrence, time for abdominal pain alleviation longer than 48 hours, interperitoneal hemorrhage and the signs of splenic rupture indicated by B ultrasonography and computed tomography. […] The indication of spleen-preservation surgery or splenectomy for patients with delayed rupture of spleen should be strictly controlled and optimal surgical procedure should be designed according to the condition of the patient.

• #69 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  How Is a Ruptured Spleen Diagnosed? […] The doctor will do a physical exam and ask about the patient’s medical history and feel their belly area. The abdominal area may feel hard and look swollen (distended) because it has filled with blood. If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed. […] Imaging tests are needed to diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on the CT scan without contrast.

• #70 Splenic Rupture: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/432823-overview

  Although protected under the bony ribcage, the spleen remains the most commonly affected organ in blunt injury to the abdomen in all age groups. […] A thorough knowledge of splenic function, anatomy, and pathophysiology is necessary to continue the progress of the last decade and to decrease the mortality rate from this common injury in the United States and worldwide. […] The clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of left upper quadrant abdominal tenderness. […] In simple terms, unstable patients suspected of splenic injury and intra-abdominal hemorrhage should undergo exploratory laparotomy and splenic repair or removal. […] The major determining factors in operative intervention in the stable patient with a splenic injury include grade of injury (American Association for the Surgery of Trauma [AAST] scale), presence of intraperitoneal blood, presence of a blush on CT scan, calculated risk of rebleeding, presence and severity of concomitant injuries, and options regarding blood transfusion. […] Signs of persistent bleeding and hemodynamic instability unresponsive to fluid and blood administration are clear indications for surgery.

• #71 Ruptured spleen: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/192110

  Doctors diagnose a ruptured spleen by examining the abdomen and using either an ultrasound or CT scan, depending on the condition of the individual. […] Internal bleeding is confirmed by low blood pressure, a high heart rate, and a positive FAST ultrasound scan. If these results indicate splenic rupture, urgent abdominal surgery is needed to determine the source of the bleeding. […] An ultrasound scan is the most sensitive diagnostic method for injuries to the abdomen, although a normal scan may not rule out splenic rupture. […] A doctor who has reason to suspect a ruptured spleen will first examine the abdomen to look for tenderness or enlargement as a result of fluid buildup, usually blood. […] In people who are hemodynamically stable, a CT scan is typically used to help determine the grade of injury. […] The grading of a ruptured spleen helps doctors determine whether surgical or non-operative management is indicated for treatment.

• #72 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #73 Ruptured spleen: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/192110

  Doctors diagnose a ruptured spleen by examining the abdomen and using either an ultrasound or CT scan, depending on the condition of the individual. […] Internal bleeding is confirmed by low blood pressure, a high heart rate, and a positive FAST ultrasound scan. If these results indicate splenic rupture, urgent abdominal surgery is needed to determine the source of the bleeding. […] An ultrasound scan is the most sensitive diagnostic method for injuries to the abdomen, although a normal scan may not rule out splenic rupture. […] A doctor who has reason to suspect a ruptured spleen will first examine the abdomen to look for tenderness or enlargement as a result of fluid buildup, usually blood. […] In people who are hemodynamically stable, a CT scan is typically used to help determine the grade of injury. […] The grading of a ruptured spleen helps doctors determine whether surgical or non-operative management is indicated for treatment.

• #74 Splenic Rupture: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/432823-overview

  Although protected under the bony ribcage, the spleen remains the most commonly affected organ in blunt injury to the abdomen in all age groups. […] A thorough knowledge of splenic function, anatomy, and pathophysiology is necessary to continue the progress of the last decade and to decrease the mortality rate from this common injury in the United States and worldwide. […] The clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of left upper quadrant abdominal tenderness. […] In simple terms, unstable patients suspected of splenic injury and intra-abdominal hemorrhage should undergo exploratory laparotomy and splenic repair or removal. […] The major determining factors in operative intervention in the stable patient with a splenic injury include grade of injury (American Association for the Surgery of Trauma [AAST] scale), presence of intraperitoneal blood, presence of a blush on CT scan, calculated risk of rebleeding, presence and severity of concomitant injuries, and options regarding blood transfusion. […] Signs of persistent bleeding and hemodynamic instability unresponsive to fluid and blood administration are clear indications for surgery.

• #75 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  How Is a Ruptured Spleen Diagnosed? […] The doctor will do a physical exam and ask about the patient’s medical history and feel their belly area. The abdominal area may feel hard and look swollen (distended) because it has filled with blood. If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed. […] Imaging tests are needed to diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on the CT scan without contrast.

• #76 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #77 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  What is the treatment for a ruptured spleen? […] Treatment for a ruptured spleen depends on numerous factors. The first is how stable your blood flow is. If you need more than two units of blood or show signs that you are still bleeding, such as low blood pressure, you will likely need surgery. […] Surgery for a ruptured spleen can involve one of two approaches. […] The first approach is a splenectomy, which is an operation to remove your spleen. The second approach is a splenic embolization, which involves a procedure to limit blood supply to your spleen via the splenic artery. The procedure reduces the pressure in your spleen, which can limit your blood loss while your injury heals. […] About 10% to 40% of people with splenic injuries will need surgery. The remainder will have non-operative treatments. Non-operative management usually involves:

• #78 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #79 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  continuing to measure your vital signs to ensure youre stable […] ordering repeat imaging […] checking your blood counts frequently to ensure you arent experiencing further bleeding. […] What are the possible complications of a ruptured spleen? […] The main complication of a ruptured spleen is excessive bleeding. Blood loss from a ruptured spleen can be so significant that it results in death without treatment. […] If you experience an accident that results in symptoms of a ruptured spleen, get help immediately. A delay in treatment could lead to more serious complications or death.

• #80 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #81 Ruptured Spleen Signs & Symptoms | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/ruptured-spleen

  A ruptured spleen is a medical emergency and needs to be treated immediately. […] A ruptured spleen may require emergency surgery or several days in the hospital. […] The type of treatment is contingent on the severity of the tear or rupture. Minor tears may only require a hospital stay and time to stop bleeding on their own. More severe tears may require emergency surgery to repair it and stop the bleeding. […] A patient that seems stable may become unstable over time as the bleeding progresses. […] The different treatment methods for a ruptured spleen include an embolization, splenorrhaphy, or splenectomy. All treatment methods require a hospital stay. […] A ruptured spleen is a life-threatening condition that requires immediate medical attention. If you have experienced a blunt force trauma to the abdomen, or suspect a ruptured spleen, please seek medical attention immediately.

• #82 Ruptured Spleen: Symptoms, Causes, Treatment

  https://www.health.com/ruptured-spleen-8638583

  A ruptured spleen occurs when the spleen tears and bleeds, usually from blunt trauma to the abdomen from car accidents, sports injuries, and falls. […] Diagnosing a ruptured spleen involves a medical history review, physical examination, and diagnostic tests. […] Imaging tests can confirm the presence and severity of a splenic rupture and internal bleeding. […] Treatment depends on the severity of the rupture and bleeding. Non-surgical treatment involves rest, observation, and symptom management to promote healing. Moderate-to-severe splenic ruptures may require surgery to repair or remove the spleen. […] Early diagnosis and treatment are important for preventing complications like shock and infection.

• #83 Ruptured spleen (ruptured spleen) – USZ

  https://www.usz.ch/en/disease/ruptured-spleen/

  A ruptured spleen is an emergency in which doctors must act quickly! This is because life-threatening bleeding can occur in the abdomen, which must be stopped quickly. […] A ruptured spleen is always an emergency in which doctors must act quickly. This is because bleeding may occur in the abdomen, which can be life-threatening. […] The diagnosis of a ruptured spleen should always be made as quickly as possible, because a ruptured spleen is an emergency! Bleeding into the abdominal cavity is life-threatening. We have to treat the ruptured spleen immediately and stop the bleeding. […] A ruptured spleen is always an emergency. Doctors must treat this immediately to avoid life-threatening consequences.

• #84 Ruptured Spleen: Causes, Symptoms, Treatment, Recovery

  https://www.healthline.com/health/ruptured-spleen

  A ruptured spleen is a life threatening medical emergency. It requires immediate medical attention. While surgery is not always necessary, timely treatment is critical. […] A ruptured spleen occurs when theres a break or tear on the spleens surface. […] If your doctor suspects a ruptured spleen, they will likely order a CT scan or ultrasound to confirm the diagnosis. […] A CT scan can show any injury or damage to the spleen. It can also detect internal bleeding and a possible hematoma, or collection of blood under the spleens surface. […] Treatment for a ruptured spleen typically falls into two camps: several days of intensive hospital care or surgery. […] If the injury or damage to the spleen is too great, or if doctors are unable to stop the internal bleeding, a splenectomy is often the treatment of choice.

• #85 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  What is the treatment for a ruptured spleen? […] Treatment for a ruptured spleen depends on numerous factors. The first is how stable your blood flow is. If you need more than two units of blood or show signs that you are still bleeding, such as low blood pressure, you will likely need surgery. […] Surgery for a ruptured spleen can involve one of two approaches. […] The first approach is a splenectomy, which is an operation to remove your spleen. The second approach is a splenic embolization, which involves a procedure to limit blood supply to your spleen via the splenic artery. The procedure reduces the pressure in your spleen, which can limit your blood loss while your injury heals. […] About 10% to 40% of people with splenic injuries will need surgery. The remainder will have non-operative treatments. Non-operative management usually involves:

• #86 Ruptured Spleen Signs & Symptoms | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/ruptured-spleen

  A ruptured spleen is a medical emergency and needs to be treated immediately. […] A ruptured spleen may require emergency surgery or several days in the hospital. […] The type of treatment is contingent on the severity of the tear or rupture. Minor tears may only require a hospital stay and time to stop bleeding on their own. More severe tears may require emergency surgery to repair it and stop the bleeding. […] A patient that seems stable may become unstable over time as the bleeding progresses. […] The different treatment methods for a ruptured spleen include an embolization, splenorrhaphy, or splenectomy. All treatment methods require a hospital stay. […] A ruptured spleen is a life-threatening condition that requires immediate medical attention. If you have experienced a blunt force trauma to the abdomen, or suspect a ruptured spleen, please seek medical attention immediately.

• #87 Diagnosis and Treatment of Atraumatic Splenic Rupture: Experience of 8 Cases

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6369493/

  Atraumatic splenic rupture (ASR) is rare but life threatening. […] The sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in ASR diagnosis was 57.1% and 85.7%, respectively. […] ASR is often life threatening due to the delay of diagnosis and treatment. […] There is still a lack of related guidelines or a standard of diagnosis and treatment for ASR. […] In this study, we showed that the incidence of ASR was 3.2% (8/251). […] The mortality of ASR is 12.2%-20%. […] The mortality of ASR was 0 in this study, which was potentially attributed to our timely diagnosis and appropriate management. […] In this series, at least 5 patients (62.5%) with 7 etiological factors belonged to atraumatic-pathological splenic rupture. […] In this study, the sensitivity of ultrasound and contrast-enhanced computed tomography (CECT) in diagnosing ASR was 57.1% (4/7) and 85.7% (6/7), respectively.

• #88

  https://journals.lww.com/acgcr/fulltext/2024/07000/a_real_gut_punch__an_unexpected_diagnosis_of.50.aspx

  Atraumatic or spontaneous splenic rupture is a rare but life-threatening complication of infectious mononucleosis. […] Understanding the broad presentation of ASR is crucial for timely recognition and appropriate intervention. […] Diagnosing ASR can present a challenge; however, the use of physical examination, laboratory findings, and imaging aid in diagnosis. […] Current guidelines recommend considering nonoperative management for hemodynamically stable patients, while splenectomy is the choice of treatment for hemodynamically unstable patients. […] Overall, ASR is a rare complication of IM; however, it is the deadliest with a mortality of 9%12.2%. […] This highlights the importance of promptly diagnosing IM and understanding the broad presentation and warning signs of splenic rupture for timely recognition and appropriate intervention.

• #89 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #90 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  What is the treatment for a ruptured spleen? […] Treatment for a ruptured spleen depends on numerous factors. The first is how stable your blood flow is. If you need more than two units of blood or show signs that you are still bleeding, such as low blood pressure, you will likely need surgery. […] Surgery for a ruptured spleen can involve one of two approaches. […] The first approach is a splenectomy, which is an operation to remove your spleen. The second approach is a splenic embolization, which involves a procedure to limit blood supply to your spleen via the splenic artery. The procedure reduces the pressure in your spleen, which can limit your blood loss while your injury heals. […] About 10% to 40% of people with splenic injuries will need surgery. The remainder will have non-operative treatments. Non-operative management usually involves:

• #91 Ruptured spleen – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/symptoms-causes/syc-20352317

  Ruptured spleen is a medical emergency that occurs as a result of a break in your spleen’s surface. […] A ruptured spleen is a medical emergency. Seek emergency care after an injury if your signs and symptoms indicate that you may have a ruptured spleen. […] A ruptured spleen can cause life-threatening bleeding into your stomach cavity. […] If you’ve been diagnosed with an enlarged spleen, ask your health care provider whether you need to avoid activities for several weeks that could cause it to rupture.

• #92 Ruptured spleen (ruptured spleen) – USZ

  https://www.usz.ch/en/disease/ruptured-spleen/

  A ruptured spleen is an emergency in which doctors must act quickly! This is because life-threatening bleeding can occur in the abdomen, which must be stopped quickly. […] A ruptured spleen is always an emergency in which doctors must act quickly. This is because bleeding may occur in the abdomen, which can be life-threatening. […] The diagnosis of a ruptured spleen should always be made as quickly as possible, because a ruptured spleen is an emergency! Bleeding into the abdominal cavity is life-threatening. We have to treat the ruptured spleen immediately and stop the bleeding. […] A ruptured spleen is always an emergency. Doctors must treat this immediately to avoid life-threatening consequences.

• #93 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  continuing to measure your vital signs to ensure youre stable […] ordering repeat imaging […] checking your blood counts frequently to ensure you arent experiencing further bleeding. […] What are the possible complications of a ruptured spleen? […] The main complication of a ruptured spleen is excessive bleeding. Blood loss from a ruptured spleen can be so significant that it results in death without treatment. […] If you experience an accident that results in symptoms of a ruptured spleen, get help immediately. A delay in treatment could lead to more serious complications or death.

• #94 Nursing Care Plan For Ruptured Spleen – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-ruptured-spleen/

  A ruptured spleen, also known as splenic rupture, is a medical emergency that demands prompt and comprehensive nursing care. […] This nursing care plan is designed to provide guidance on the care and interventions necessary for patients with a ruptured spleen. […] Timely and efficient nursing care is vital in minimizing the risk of severe bleeding and other complications associated with a ruptured spleen, ultimately contributing to the patients recovery and well-being. […] A comprehensive nursing assessment is critical when caring for a patient with a suspected or confirmed ruptured spleen. […] Coordinate diagnostic imaging studies, such as abdominal ultrasound or computed tomography (CT) scan, to confirm the presence of a ruptured spleen and evaluate the extent of injury. […] Nursing diagnoses for a patient with a ruptured spleen should focus on addressing the potential complications and challenges associated with this condition.

• #95 Nursing Care Plan For Ruptured Spleen – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-ruptured-spleen/

  This diagnosis addresses the risk of inadequate tissue perfusion and shock due to severe bleeding. […] Patients with a ruptured spleen may undergo surgery, and this diagnosis addresses the potential risk of infection postoperatively. […] Education is essential to ensure the patient and their family understand the diagnosis, treatment options, and expected outcomes. […] Nursing care for a patient with a ruptured spleen requires a multidisciplinary approach, emphasizing patient safety, pain management, and emotional support. […] Effective communication and coordination with the healthcare team are crucial for managing this complex and potentially life-threatening condition. […] By implementing these nursing interventions and fostering a multidisciplinary approach, healthcare providers contribute to positive patient outcomes and strive to ensure the patients safe and successful recovery from a ruptured spleen.

• #96 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  continuing to measure your vital signs to ensure youre stable […] ordering repeat imaging […] checking your blood counts frequently to ensure you arent experiencing further bleeding. […] What are the possible complications of a ruptured spleen? […] The main complication of a ruptured spleen is excessive bleeding. Blood loss from a ruptured spleen can be so significant that it results in death without treatment. […] If you experience an accident that results in symptoms of a ruptured spleen, get help immediately. A delay in treatment could lead to more serious complications or death.

• #97 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #98 Nursing Care Plan For Ruptured Spleen – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-ruptured-spleen/

  This diagnosis addresses the risk of inadequate tissue perfusion and shock due to severe bleeding. […] Patients with a ruptured spleen may undergo surgery, and this diagnosis addresses the potential risk of infection postoperatively. […] Education is essential to ensure the patient and their family understand the diagnosis, treatment options, and expected outcomes. […] Nursing care for a patient with a ruptured spleen requires a multidisciplinary approach, emphasizing patient safety, pain management, and emotional support. […] Effective communication and coordination with the healthcare team are crucial for managing this complex and potentially life-threatening condition. […] By implementing these nursing interventions and fostering a multidisciplinary approach, healthcare providers contribute to positive patient outcomes and strive to ensure the patients safe and successful recovery from a ruptured spleen.

• #99 Ruptured Spleen Signs & Symptoms | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/ruptured-spleen

  A ruptured spleen is a medical emergency and needs to be treated immediately. […] A ruptured spleen may require emergency surgery or several days in the hospital. […] The type of treatment is contingent on the severity of the tear or rupture. Minor tears may only require a hospital stay and time to stop bleeding on their own. More severe tears may require emergency surgery to repair it and stop the bleeding. […] A patient that seems stable may become unstable over time as the bleeding progresses. […] The different treatment methods for a ruptured spleen include an embolization, splenorrhaphy, or splenectomy. All treatment methods require a hospital stay. […] A ruptured spleen is a life-threatening condition that requires immediate medical attention. If you have experienced a blunt force trauma to the abdomen, or suspect a ruptured spleen, please seek medical attention immediately.

• #100 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  The spleen is the visceral organ most frequently injured in blunt abdominal trauma. Trauma is also the most common cause of a ruptured spleen. […] This activity reviews the evaluation and management of patients with splenic rupture and highlights the role of the interprofessional team in the management of patients with this condition. […] Explain how to evaluate a patient for splenic rupture. […] Evaluation for splenic injury is therefore warranted if left lower rib fractures are identified. Up to 20% of adults with left lower rib fractures may have a subsequent splenic injury. […] A splenic injury may not always be clinically apparent, and spontaneous splenic rupture or pathologic splenic rupture can occur after negligible trauma or insignificant events. […] Ultrasound can be very helpful and highly accurate in the diagnosis of significant splenic injury but is limited in detecting active bleeding, pseudoaneurysm, or early in the evaluation when blood loss is minimal.

• #101 Splenic Rupture: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/432823-overview

  Although protected under the bony ribcage, the spleen remains the most commonly affected organ in blunt injury to the abdomen in all age groups. […] A thorough knowledge of splenic function, anatomy, and pathophysiology is necessary to continue the progress of the last decade and to decrease the mortality rate from this common injury in the United States and worldwide. […] The clinical presentation of splenic injury is highly variable. Most patients with minor focal injury to the spleen complain of left upper quadrant abdominal tenderness. […] In simple terms, unstable patients suspected of splenic injury and intra-abdominal hemorrhage should undergo exploratory laparotomy and splenic repair or removal. […] The major determining factors in operative intervention in the stable patient with a splenic injury include grade of injury (American Association for the Surgery of Trauma [AAST] scale), presence of intraperitoneal blood, presence of a blush on CT scan, calculated risk of rebleeding, presence and severity of concomitant injuries, and options regarding blood transfusion. […] Signs of persistent bleeding and hemodynamic instability unresponsive to fluid and blood administration are clear indications for surgery.

• #102 Ruptured spleen – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/diagnosis-treatment/drc-20352322

  Tests and procedures used to diagnose a ruptured spleen include: […] Your health care provider will press on your abdomen to determine the size of your spleen and whether it’s tender. […] Blood tests will evaluate factors such as platelet count and how well your blood clots. […] In emergency situations, your health care team might either use an ultrasound or draw a sample of fluid from your stomach with a needle. If the sample reveals blood in your stomach, you might be referred for emergency surgery. […] If your diagnosis isn’t clear, your provider might recommend a CT scan of the stomach, possibly with contrast dye, or another imaging test to look for other possible causes of your symptoms. […] You might have periodic follow-up CT scans to check whether your spleen has healed or to determine whether you need surgery.

• #103 Ruptured Spleen: Symptoms, Causes, Surgery, and Recovery

  https://www.webmd.com/digestive-disorders/ruptured-spleen

  How Is a Ruptured Spleen Diagnosed? […] The doctor will do a physical exam and ask about the patient’s medical history and feel their belly area. The abdominal area may feel hard and look swollen (distended) because it has filled with blood. If there has been a great deal of blood loss from the spleen, the patient may have low blood pressure and a rapid heart rate. Sudden low blood pressure in someone who is believed to have a spleen injury, particularly a young person, is a sign that the condition is especially severe, and emergency surgery is needed. […] Imaging tests are needed to diagnose a ruptured spleen. A computed tomography (CT) scan of the abdomen is one of the most common methods used. During the test, a special substance, called contrast, is injected into a vein, usually in the arm. The contrast helps the doctor determine the amount of bleeding from the spleen. Active bleeding from the spleen may not be seen on the CT scan without contrast.

• #104 Ruptured spleen: Symptoms, treatment, and causes

  https://www.medicalnewstoday.com/articles/192110

  Doctors diagnose a ruptured spleen by examining the abdomen and using either an ultrasound or CT scan, depending on the condition of the individual. […] Internal bleeding is confirmed by low blood pressure, a high heart rate, and a positive FAST ultrasound scan. If these results indicate splenic rupture, urgent abdominal surgery is needed to determine the source of the bleeding. […] An ultrasound scan is the most sensitive diagnostic method for injuries to the abdomen, although a normal scan may not rule out splenic rupture. […] A doctor who has reason to suspect a ruptured spleen will first examine the abdomen to look for tenderness or enlargement as a result of fluid buildup, usually blood. […] In people who are hemodynamically stable, a CT scan is typically used to help determine the grade of injury. […] The grading of a ruptured spleen helps doctors determine whether surgical or non-operative management is indicated for treatment.

• #105 Splenic Rupture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525951/

  CT has become the mainstay of stable patient evaluation since it can provide splenic injury severity and assessment of other abdominal organs. […] Splenic injury is classified based on CT findings according to the American Association for the Surgery of Trauma (AAST) Organ Injury Scale. […] Treatment is dependent on the severity and etiology of rupture, as well as the hemodynamic stability of the patient. […] Non-operative treatment is attempted in 60% to 90% of patients with blunt traumatic splenic injuries out of a desire to preserve splenic function. […] Exploratory laparotomy is, however, indicated if continuing hemodynamic instability or if the patient has required more than 4 units of blood during a 48-hour period. […] Splenic rupture is best managed by an interprofessional team that includes a surgeon, radiologist, intensivist and the ICU nurses.

• #106 Symptoms of a Ruptured Spleen and When to Seek Help

  https://www.healthline.com/health/symptoms-of-a-ruptured-spleen

  continuing to measure your vital signs to ensure youre stable […] ordering repeat imaging […] checking your blood counts frequently to ensure you arent experiencing further bleeding. […] What are the possible complications of a ruptured spleen? […] The main complication of a ruptured spleen is excessive bleeding. Blood loss from a ruptured spleen can be so significant that it results in death without treatment. […] If you experience an accident that results in symptoms of a ruptured spleen, get help immediately. A delay in treatment could lead to more serious complications or death.

• #107 Splenic Rupture Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/432823-workup

  Active bleeding from the splenic parenchyma can be missed with a noncontrast CT scan. […] A splenic contrast blush noted by a helical CT scanner has a greater propensity to require splenic exploration in most series. […] Angiography is rarely the first choice for evaluation of the patient with a splenic injury, but it is being used more frequently for primary therapeutic management of splenic injuries. […] DPL is a method of rapidly determining if free intraperitoneal blood is present. This test is especially useful in the hypotensive patient. […] Histologic findings may help to explain why a minor trauma resulted in a major splenic injury. Splenic rupture may follow after a seemingly minor transfer of kinetic energy because of organ expansion with capsular thinning or an abnormal internal architecture with reduced elasticity to the parenchyma. […] Splenic injury is graded using the standards published by the Organ Injury Scaling Committee of the AAST. Categories range from grade I (minor) to grade V (major) and correlate to the need for laparotomy.

• #108 Possible infectious causes of spontaneous splenic rupture: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-8-396

  The causes of ASR are varied and can be classified into seven main categories: neoplastic, infectious, hematological, inflammatory, iatrogenic, primary splenic causes or idiopathic. Proportionally, neoplasia and infection account for more than half of the cases. […] Given that infections explain approximately one-quarter of ASR cases, infectious etiologies should be on the differential when a patient presents with ASR. A detailed history and physical are required to screen for infectious causes although delineating the exact infectious etiology can be challenging with the limitation of serological diagnostics.

• #109 Ruptured Spleen: Symptoms, Causes, Treatment

  https://www.health.com/ruptured-spleen-8638583

  A ruptured spleen occurs when the spleen tears and bleeds, usually from blunt trauma to the abdomen from car accidents, sports injuries, and falls. […] Diagnosing a ruptured spleen involves a medical history review, physical examination, and diagnostic tests. […] Imaging tests can confirm the presence and severity of a splenic rupture and internal bleeding. […] Treatment depends on the severity of the rupture and bleeding. Non-surgical treatment involves rest, observation, and symptom management to promote healing. Moderate-to-severe splenic ruptures may require surgery to repair or remove the spleen. […] Early diagnosis and treatment are important for preventing complications like shock and infection.

• #110 Ruptured Spleen: Causes, Symptoms, Treatment, Recovery

  https://www.healthline.com/health/ruptured-spleen

  A ruptured spleen is a life threatening medical emergency. It requires immediate medical attention. While surgery is not always necessary, timely treatment is critical. […] A ruptured spleen occurs when theres a break or tear on the spleens surface. […] If your doctor suspects a ruptured spleen, they will likely order a CT scan or ultrasound to confirm the diagnosis. […] A CT scan can show any injury or damage to the spleen. It can also detect internal bleeding and a possible hematoma, or collection of blood under the spleens surface. […] Treatment for a ruptured spleen typically falls into two camps: several days of intensive hospital care or surgery. […] If the injury or damage to the spleen is too great, or if doctors are unable to stop the internal bleeding, a splenectomy is often the treatment of choice.

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