Spleen injuries

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The spleen is the second most frequently injured abdominal organ in children. This is because it is not protected by the rib cage.  

The spleen is located in the left upper side of the abdomen, just under the rib cage. The spleen is an important part of the body’s defence against certain bacteria and infection.  It also filters blood and removes old blood cells and other debris.

Spleen injuries are graded according to the depth of the contusion or the laceration, from grade I (minor) to grade IV (shattering of the spleen). 

What are the common causes of a spleen injury in children and adolescents?

What are the common causes of a spleen injury in children and adolescents?

Spleen injuries happen when there is a blunt injury to the abdomen. Most blunt injuries to the spleen are due to:

  • Fall from a height
  • Motor vehicle collision
  • Sports
Common signs and symptoms of a spleen injury:

Common signs and symptoms of a spleen injury:

A child with an injured spleen may have some or all of the following signs and symptoms:

  • Pain in the upper left side of the abdomen
  • Pain in the left shoulder caused by blood irritating the diaphragm 
  • Broken ribs on the left side
  • Pale, sweaty skin
  • Rapid pulse
  • Light-headedness
What is the treatment for a spleen injury?

What is the treatment for a spleen injury?

  • Children with a spleen injury will be admitted to the hospital so they can be watched closely. Those with a grade IV injury are usually hospitalized in the Intensive Care Unit. Unstable children may need an emergency operation first.
  • Bed rest in the hospital until symptoms have disappeared 
  • Several physical exams and blood tests are done to determine your child’s condition
  • Intravenous fluids
  • Blood transfusions if needed
  • An abdominal ultrasound and/or CT scan to be able to see the condition of your child’s spleen
If your child’s condition becomes unstable while in hospital, one of two operations may be performed:

If your child’s condition becomes unstable while in hospital, one of two operations may be performed:

  • splenorrhaphy: repair of the spleen
  • splenectomy: removal of the spleen
What are the complications following a spleen injury?

What are the complications following a spleen injury?

Most children with a spleen injury are successfully treated without an operation. If the spleen has been removed, your child will need antibiotics and immunization against common bacteria.

What happens once your child is discharged from the hospital following a spleen injury?

What happens once your child is discharged from the hospital following a spleen injury?

  • Your child will be scheduled for a follow-up evaluation by the surgeon
  • One week of bed rest at home
  • Return to “normal” activities, not including contact sports:
              Grade I: 3 weeks 
              Grade II: 4 weeks
              Grade III: 5 weeks  
              Grade IV: 6 weeks
  • No contact sports for 3 months
If your child had his/her spleen removed:

If your child had his/her spleen removed:

  • he/she will need prophylactic vaccines and antibiotics
  • he/she should wear a MedicAlert bracelet and carry the card
  • You should seek medical attention right away if your child has any signs of infection, even minor (including fever)
What to do to prevent a spleen injury

What to do to prevent a spleen injury

You can help prevent a spleen injury by avoiding trauma to the abdomen.  To do this, you should:
  • Always use the proper car seat, seat belt and shoulder harness when your child is riding in a car.
  • Make sure your child wears proper safety gear at all times when playing sports.
Reviewed by Trauma specialists at the Montreal Children’s Hospital.
Last updated: July 2013, January 2016

Trauma

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