SPLEEN RUPTURE |
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DESCRIPTIONBleeding of a ruptured spleen can be fatal. The spleen is vulnerable to injury, particularly if it is enlarged due to any underlying disorder (infectious mononucleosis is the most common). Spleen injuries are infrequent in athletes but, when they do occur, they can be disastrous. Appropriate health care usually involves surgery.
SIGNS & SYMPTOMS
Recent injury to the child's abdomen or flank.
Rib fracture on the left side.
Vomiting.
Abdominal pain and tenderness.
Pain in the child's left shoulder or the left side of the neck.
Rapid heart rate.
Low blood pressure.
Other signs of shock: pale, moist and sweaty skin; anxiety with feelings of impending doom; shortness of breath and rapid breathing; disorientation and confusion.
CAUSES
Direct injury to the child's left upper abdomen or left side of the chest.
RISK FACTORS
Contact sports; bleeding disorders such as hemophilia; infectious mononucleosis or any other illness that causes spleen enlargement in the child.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should avoid causes and risk factors when possible and should not return to athletic activities until a spleen enlarged by disease has returned to normal.
BASIC INFORMATION
MEDICAL TESTS
Before surgery: blood and urine studies; X-rays of the abdomen and chest.
After surgery: examination of all removed tissue; additional blood studies.
POSSIBLE COMPLICATIONS
At the time of the child's injury: rapid deterioration due to internal bleeding, possibly leading to death.
Following surgery: excessive bleeding; infection; incisional hernia; lung collapse; inflammation of the pancreas; deep-vein blood clots; pneumonia.
PROBABLE OUTCOME
Expect the child to heal completely if no complications occur. Allow about 4 weeks for recovery from surgery.
TREATMENT
FIRST AIDCover the child with a blanket to combat shock, and go to the nearest emergency facility. Do not give the child any water, food, or pain relievers.
HOME CARE
If surgery is required, your surgeon will supply postoperative instructions.
MEDICATION
Do not give pain relievers at the time of injury. They may mask symptoms.
After the child's surgery, your doctor may prescribe:
-- Pain relievers. Don't give the child prescription pain medication longer than 4 to 7 days. Use only as much as your child needs.
-- Antibiotics to fight infection.
-- Pneumonia vaccinations.
-- Stool softeners to prevent constipation.
-- Non-prescription drugs such as acetaminophen for minor pain.
ACTIVITY
The child should return to school, work, play, and normal activity as soon as possible. This reduces postoperative depression, which is common.
The child should avoid vigorous exercise for 6 weeks after surgery.
The child can resume driving 4 weeks after returning home.
DIET & FLUIDS
No food or water for the child before surgery.
The child should drink a clear liquid diet until the gastrointestinal tract functions again. Then serve the child a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk, and eggs. Increase the child's fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATION
Your child's rehabilitation exercises must be individualized. Follow your doctor's or surgeon's directions.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child receives any abdominal injury and the symptoms last longer than a few minutes, worsen, or recur within hours or days. This may be an emergency!
Any of the following occur after surgery: your child develops signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever); pain, swelling, redness, drainage, or bleeding increase in the surgical area.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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