Best Practice Case Studies-Spleen Injuries

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Spleen injuries in athletes are uncommon but can be life-threatening if not properly diagnosed, especially after abdominal trauma. Typical causes include activities like football tackling, hockey checking, horse riding, and bike accidents. While often associated with infectious mononucleosis (IM), where 50-60% experience splenomegaly and 1-2 in 1000 suffer splenic rupture, any athlete can be affected. Most splenic ruptures in IM patients occur around day 14 of illness, particularly in males under 30.<br /><br />Symptom identification is critical: signs include left upper abdominal or rib pain, referred pain to the left shoulder, abdominal bruising, low blood pressure, pallor, and elevated heart rate. Risk factors include active IM, contact sports, extreme sports, and improper equipment use.<br /><br />For stable patients, assessment involves checking vital signs, taking a history, and conducting exams; lab tests and a CT scan might be used. Over 90% of children and 50-70% of adults with spleen injuries can be treated without surgery, requiring rest and restricted activity.<br /><br />Unstable patients, exhibiting low blood pressure or rapid heart rate, need immediate emergency care. Treatments may include intravenous fluids and, in some cases, blood transfusions or surgery.<br /><br />Prevention involves using padded bicycle handlebars for children and ensuring proper equestrian tack. IM patients should avoid high-risk activities for at least 21 days, following medical advice.<br /><br />Return to play is individualized; light activities are allowed after three months, avoiding contact sports. Post-IM, non-contact athletes may resume in 21 days, contact athletes in 30 days, if asymptomatic and the spleen is not palpable. Serial imaging may ensure full recovery before sports resumption. For more guidance, visiting a sports medicine physician is recommended. The AMSSM provides such resources and professionals.

Meta Tag

Edition 2nd Edition

Related Case 2nd Edition, Case 01

Topic Abdomen

Keywords

2nd Edition, Case 01

2nd Edition

Abdomen

spleen injuries

athletes

abdominal trauma

infectious mononucleosis

splenic rupture

symptom identification

contact sports

treatment

prevention

sports medicine