A small, four-inch, spongy organ called the spleen is surprisingly one of the most commonly injured organs in the body. In the past, the treatment for an injured spleen was to remove it via surgery, as the prevalent belief was that the spleen was unimportant, and didn’t serve much of a purpose within the human anatomy. As it turns out, the spleen is an integral part of our immune system with several different functions relating to our keeping our blood clean and bacteria-free.
Function of the Spleen
The spleen’s functions are three-fold. It mainly acts as a blood filter for removing bacteria, but it also recycles old red blood cells, and stores white blood cells and platelets. The types of bacteria the spleen filters include those that cause pneumonia and meningitis among others.Without the spleen, red blood cell recycling isn’t deeply affected, but white blood cell function and resistance to infection are. Sepsis, pneumonia, and streptococcal infections are much more common after a splenectomy when compared to infection rates of those who still have a spleen. This is due to the lower white blood cell count as well as the reduced filtering of blood that occurs when the spleen isn’t present.
Injuries to the Spleen
Any suspected spleen injury needs to be immediately assessed by a medical professional who is capable of rendering an accurate diagnosis. In the case of an accident, the nearest hospital emergency room personnel will perform these assessments, which may include manual palpation of the abdomen, CT scans, and blood tests.
Nearly half of all individuals with a spleen injury caused by an accident will require an emergency surgery, but this doesn’t automatically mean that the spleen will be removed. It can be repaired, as can the vessels that bring blood to and from the spleen.
Injuries that penetrate the spleen must be surgically treated, normally because there are other abdominal injuries that are also present and need surgical attention. Injured areas that are near the spleen could involve the pancreas, diaphragm, stomach, or other internal organs.
Symptoms of an injured spleen include, but are not limited to:
- Left-side abdominal pain or tenderness
- Left-side shoulder pain
- Abdominal rigidity
- Increased heart rate
- Pale skin
Delayed bleeding can occur from days to weeks after a spleen injury has occurred. A CT scan will often show that the spleen has been injured, but bleeding will occur later.
Symptoms of internal bleeding that may be immediately present, or delayed, may include:
- Blurry vision
Due to the location of the spleen within the human body, it is at high risk of traumatic injury from car accidents. A severe blow to the left side of the body during the impact of a car accident could result in splenic injuries that can range from simple bruising to a complete rupture.
Degrees of Spleen Injuries
There are five degrees of splenic injury based on how severe the trauma is. The American Association for the Surgery of Trauma has a number grading system using a scale from I to V.
The grading system is as follows:
- I—a blood clot that isn’t currently growing;
- II—a laceration of the outer wall of the spleen;
- III—a deep laceration into the interior of the spleen;
- IV—a significant area of the spleen that is devoid of circulation due to an injured or damaged artery; or
- V—the spleen has been injured such that it is separated into two or more pieces (also referred to as a ruptured spleen).
Surgery for Spleen Injuries
In the event of severe trauma to the spleen, surgery will be necessary, especially in the case of a ruptured spleen. Surgery has three potential effects:
- Repair of the injuries using stitches or other methods.
- Removing the spleen, resulting in a higher chance of infection.
- Removing only the damaged part of the spleen, keeping the rest of the spleen intact.
All of these procedures are performed laparoscopically through small incisions in your abdomen. A tiny camera with a light is inserted, sending images to a monitor so that the surgeon knows where the injuries are, and knows where to insert and use surgical tools. Most spleen surgeries are performed laparoscopically, but some do still require a large incision in order to access the spleen.
While spleen surgery is relatively safe, any surgery comes with risks such as blood loss and infection.
Non-Operative Treatment of a Spleen Injury
Non-operative treatment (NOT) of spleen injuries is indicated in over half of all splenic injury cases. If a patient with a spleen injury is awake and able to communicate, the physician may palpate to look for abdominal pain that could help them properly diagnose the injuries. A CT scan may still be indicated to look for free fluid within the abdominal cavity, indicating internal bleeding that would necessitate surgery. Low blood pressure another symptom that may lead to the decision to do surgery, as significant loss of blood will cause the lessening of pressure.
The spleen has been proven to self-heal in a significant number of cases, thus reducing the need for surgical intervention. If only a portion of the spleen is damaged beyond repair, blood flow to that portion can be stopped, and surgery performed to remove the damaged part while leaving the rest of the spleen intact. This is far preferred to removing the spleen altogether and suffering the potential consequence of a continually greater risk of infection.
If you’ve been in a car accident or suffered a fall due to someone else’s negligence, you are entitled to compensation for your medical bills, lost wages, and pain and suffering. The attorneys at The Sevey Law Firm want you to know that we’re here for you. Make an appointment to come in for a consultation and we’ll give you the benefit of our decades of legal experience. We’ll hear your story, ask questions to obtain the information we need, and give you an educated opinion on the strength of your case, and its potential outcome. Call us at (916) 788-7100 or contact us online to set up an appointment.