Ruptured spleen Dr Rob Hicks Few people know how important their spleen is, but if it ruptures the consequences can be severe.

In this article

What is the spleen? What's the cause?

What are the symptoms? What's the treatment?

The spleen is located just beneath the left side of the diaphragm, under the ribs, and is shaped like a loosely clenched fist.

Its major role is filtering out foreign organisms that can infect the bloodstream, and removing old red bloods cells and recycling them.

During a baby's time in the womb, the spleen manufactures red blood cells, a role that's taken over by bone marrow after birth. It can also act as a reservoir for blood.

The spleen's vulnerable location means it's at risk of injury. A severe blow to the stomach area can crush the spleen, tearing its covering and the tissue inside.

A ruptured spleen is the most common serious complication of an abdominal injury and may occur as a consequence of road traffic accidents, sports injuries and violent, physical attacks.

The abdomen usually feels tender and painful when the spleen ruptures. Blood leaks into the abdomen, causing irritation with subsequent tenderness and pain. Classically, a patient with a ruptured spleen describes feeling left shoulder-tip pain.

If the leak of blood is gradual, symptoms may not occur until the blood supply to the body is diminished. This will result in low blood pressure and light-headedness, blurred vision, confusion and loss of consciousness, as the oxygen supply to the heart and brain is affected.

Untreated, a ruptured spleen can be fatal, so it requires urgent medical and surgical treatment. Immediate blood transfusions are given to maintain an adequate blood supply to the organs of the body, and emergency surgery is performed to stop the leak of blood.

Sometimes, if the rupture is only small, it's possible for the surgeon to repair the spleen. However, usually the entire spleen needs to be removed in an operation called a splenectomy.

It's important that those who've had their spleen removed protect themselves against infection. In particular, they should be vaccinated against pneumococcal infection.

This article was last medically reviewed by Dr Rob Hicks in July 2006.