Spleen Injuries

The spleen is a curved, disc-shaped organ four inches around and about two inches thick. It sits under the lower part of the left side of the ribs. The spleen filters infections and worn out blood cells from the body. People without a spleen have a harder time fighting off some infections.

The spleen is soft and is surrounded by a tough covering, or capsule. If your child is hit or falls in a way that causes the left chest or upper abdomen to hit the spleen, your child may suffer a spleen injury. Not all spleen injuries are the same. Your child may have a mild bruise or a little tear that causes bleeding; or the spleen may be broken into several pieces.

The following are symptoms of a spleen injury:

• Pain in the left side of the abdomen
• Pain in left shoulder
• Lightheaded feeling
• Paleness
• Weak pulse

Spleen injuries may be diagnosed in different ways.

• Most children with spleen injuries have pain in their left abdomen and their left shoulder. Your child's doctor will press on and/or under the ribs of the lower left side to see if the area is tender.
• A child with a severe spleen injury may feel lightheaded, appear pale, and have a weak pulse, all of which suggest the presence of internal bleeding.

If you think your child has a possible spleen injury, contact your child's physician for an immediate evaluation.

Diagnostic tests

There are many tests that may be done to confirm a spleen injury. The most common is a computerized tomogram, or CT scan, of the abdomen. This is a diagnostic procedure that uses a combination of X-rays and computer technology to produce cross-sectional images both horizontally and vertically of the body.

A CT scan shows detailed images of any part of the body. It not only shows whether or not the spleen is injured, but also how badly it's injured and if any other abdominal injuries are present.

Traditionally, children with an injured spleen underwent an operation to remove it, a so-called splenectomy. Over the past 30 years, surgeons have learned that more than 90 percent of children with an injured spleen can heal without an operation, saving the spleen's important infection fighting role.

To get the spleen to heal, the child needs to remain in bed in the hospital until their spleen has stopped bleeding, and they must then restrict their participation in sports or other vigorous activities to keep their spleen from being reinjured. Sometimes, if the child is in shock, or the spleen doesn't stop bleeding on its own, an operation is needed to remove or repair the spleen.