Forms

There are a total of five different forms of splenic rupture. This is due to the anatomy of the spleen. It is surrounded by a protective capsule.

If only the capsule ruptures, the bleeding is not particularly severe. If the capsule ruptures and the tissue of the spleen is torn, the injury is much worse. From grade 3 to grade 5, conservative therapy is no longer sufficient; surgery must be performed as soon as possible.

Grade 1: The capsule is ruptured, a bleeding occurs, but it is small and does not get bigger
Grade 2: The capsule and the spleen tissue are injured, but the bleeding is not particularly severe, since only smaller blood vessels are affected.
Grade 3: Capsule, spleen tissue and larger vessels are affected.
Grade 4: Capsule, spleen tissue and the large feeding vessels are injured
Grade 5: Spleen is completely ruptured and thus no longer supplied with blood.

Symptoms

The symptoms vary depending on the form of the splenic laceration. If only the capsule is affected, there are often no symptoms at first. However, if the internal bleeding is not stopped, symptoms of anemia can occur, i.e. the patient may feel flabby and tired, may not be able to concentrate properly, and dizziness and confusion may occur.

If prolonged bleeding leads to blood accumulation in the abdominal cavity, this can cause abdominal pain, as well as pain in the shoulder and neck area due to nerve irritation. If there is a large accumulation of blood in the abdomen, the abdomen becomes hard, which in medicine is also known as “board-hard” abdomen. If not only the capsule is affected, but also the tissue itself, the symptoms are more severe. The patient then complains of severe pain in the abdominal area, and shock (circulatory collapse) with rapid heartbeat, low blood pressure and rapid breathing, which, if not treated, leads to clouding of consciousness and in the worst case, death.