Maybe a dumb question, but why is a ruptured spleen bad?

[CBG23]

So, I was reading about mono the other day and read that the enlarged spleen that accompanies the infection is highly susceptible to rupture, which can be fatal. My question is exactly why are the consequences of splenic rupture so severe?

Is it because you've basically created a way for blood to be lost? Meaning the blood that would normally flow into the splenic cords now just flows into the abdomen and cannot not be returned to the circulation - so you basically die of hemorrhagic shock?

I was thinking about whether or not the dispersal of WBCs into the abdominal cavity would contribute adversely in any way, but couldn't think of any reason it would - at least not something that would cause a problem before the hemorrhage killed you first...

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[DrYoda]

Is it because you've basically created a way for blood to be lost?

Yep.

 

[WashMe]

So, I was reading about mono the other day and read that the enlarged spleen that accompanies the infection is highly susceptible to rupture, which can be fatal. My question is exactly why are the consequences of splenic rupture so severe?

Is it because you've basically created a way for blood to be lost? Meaning the blood that would normally flow into the splenic cords now just flows into the abdomen and cannot not be returned to the circulation - so you basically die of hemorrhagic shock?

I was thinking about whether or not the dispersal of WBCs into the abdominal cavity would contribute adversely in any way, but couldn't think of any reason it would - at least not something that would cause a problem before the hemorrhage killed you first...

I'm going to go with the severe blood loss, but I'm not sure.

 

[bioteach]

internal bleeding - lots of it

 

[gulnosh]

splenic artery is a highly tortuous vessel..so blood loss is severe..
hemorhagic shock.

 

[Meerkatology]

also any kind of bleeding into abdominal cavity is not good, you don't need to go in shock for it to be bad, when you bleed into a cavity that normally dont have blood, you can get reactions and all kinds of yucky stuff

you know , like eww?


and the word "rupture" is never good... unless the patient is 40 weeks pregnant.

 

[WellWornLad]

The spleen has an open circulation - blood flows en masse through the reticular fibrous framework without typical blood vessels. Ruptures therefore tend to be larger and much harder to close than those coming from a closed (vascular) source. It also stores a good deal of blood and receives a fair amount of the total cardiac output (~5%), so the immediate blood loss tends to be large.

 

[45408]

Took a ruptured spleen out of a young guy last month after he crashed whatever vehicle he was on. Total bloodbath with ~2.5 liters of pure blood in his belly. He was young and healthy, so he rebounded quickly, but it was one of those cases where you walk out and realize he'd be dead shortly if we hadn't intervened.

 

[werd]

as above, the spleen is particularly bad to rupture due to hemorrhage. very high blood flow through the spleen, and you can bleed out fast with rupture. it's a non-essential organ though.. main consequence to not having one is increased susceptibility to encapsulated bacteria and a few other organisms.

 

[Siggy]

Rupturing the spleen is essentially like putting a hole in the casing of a pool filter.

 

[reedman]

i once say an EM resident get very serious when he saw a ruptured spleen on CT. that chick was sent to the OR and opened within 10 minutes.

 

[TooMuchResearch]

Rupturing the spleen is essentially like putting a hole in the casing of a pool filter.

Waiting for punch line 😕

 

[ApothecaryReady]

Punch line? Siggy is simply comparing the circulatory system of the human body to that of a swimming pool. The pool filter is an area where much liquid flows through a relatively open area, much like the way that the spleen is an area where much blood flows through a relatively open area. If a hole is put in the spleen or the pool filter, there is no easy way to plug the hole and much of the liquid escapes.

 

[Siggy]

Waiting for punch line 😕

The Aristocrats?


...and to add to ApothecaryReady's description of my analogy (which was spot on), much like the filter casing is made of metal to both keep outside things out and inside things in, the spleen is an encapsulated organ with a tougher exterior than most other organs.

 

[Disinence2]

As long as the patient is stable, a Splenic bleeding isn't always that big of a deal.

 

[Encephalectomy]

splenic bleeding and a full out rupture are not the same thing. But yea my small group leader the 1st semester of med school was this retired old general/vascular surgeon and he made a big point about how incredibly large the cojones of the surgeon who decided that he wasn't going to do splenectomies on all the splenic bleeders must have been and who basically showed that for anything short of a full rupture, especially in a young person, that they do fine if you leave it in, so many fewer splenectomies now than back then.

 

[greatnt249]

The Aristocrats?

👍

As to the question this response was directed toward...seriously? Poke a hole in the side of a full pool and see what happens.