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. 2004 Jun;39(2):201-205.

Splenic Artery Avulsion in a High School Football Player: A Case Report

David J. Ralston  1 , Michael J. Scherm
Affiliations

Splenic Artery Avulsion in a High School Football Player: A Case Report

David J. Ralston et al. J Athl Train. 2004 Jun.

Abstract

OBJECTIVE: To present the case of a high school football player who sustained avulsion of 2 branches of the splenic artery from his spleen as he was tackled and landed on the football. BACKGROUND: A high school football player was tackled and fell onto the football, left side first. He was examined by a certified athletic trainer and an internist. On evaluation, he had a positive Kehr sign, exquisite left upper abdominal quadrant tenderness, and complaint of nausea. He also exhibited signs of the onset of shock, including diaphoresis, a rapid pulse, and hypotension. He was immediately transported by ambulance to the local emergency facility. DIFFERENTIAL DIAGNOSIS: Splenic rupture, splenic laceration, splenic artery avulsion, or ruptured viscus. TREATMENT: Emergency surgery was performed, with removal of 2800 mL of blood and ligation of the 2 arterial branches avulsed from the spleen. The patient fully recovered within 6 weeks and was cleared to resume all sports activities. UNIQUENESS: Injury to the spleen in football is a known yet very uncommon injury. Even more unusual is the avulsion of splenic artery branches from the spleen. CONCLUSIONS: It is critical that athletic trainers and team physicians have an understanding of the mechanisms, signs, and symptoms of splenic injury. Because the spleen is a highly vascular organ, severe hemorrhage can be fatal in just minutes if not recognized and appropriately treated.

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Figures

Figure 1
Figure 1
Subject was tackled and fell onto the football.
Figure 2
Figure 2
Computed tomography scan showing free fluid.
Figure 3
Figure 3
Anatomy of the spleen.
Figure 4
Figure 4
Comparison of spleen location in children and in adults.
See this image and copyright information in PMC

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