ZocdocAnswersI feel like my spleen is hurting, what could it be?

Question

I feel like my spleen is hurting, what could it be?

hi i had a fall 18 days ago and landed on my stomach - I had some minor bruising but struggled to move and went to A&E. They said I just had some tender bruising and did an ultrasound to check my organs. but now everything has gone other than a pain coming from under my lower left ribs to the side. Thought maybe my rib was cracked but now that doesn't seem to be the case. I find it hard to sit up when laying down, and tough to tie shoelace etc.... really quite uncomfortable. Just feel like it must be more than the bruising, which has gone.

Answer

Residual pain after trauma is very common and can be due to a number of causes. Some of these causes can be serious and some of them are minor, so it would be best to see a doctor regarding your persistent pain. When you do see a doctor, you can discuss the following possibilities. You may have a splenic laceration or hematoma that can cause left-sided abdominal pain. The ultrasound can sometime detect this pathology, but a CT scan is much more sensitive. If you did not have a CT scan, then it is possible you have an undetected splenic injury. In this case, often there is not much to do but control your pain and avoid any further physical contact. However, there can be dangerous changes in the vascular leading to the spleen after a splenic laceration/hematoma, and a doctor can advise you on whether it would be worth obtaining further imaging of your abdomen. A second possibility is that you have a right-sided rib fracture. A chest x-ray, if one was obtained initially, is not 100% sensitive for detecting rib fractures and a chest CT would be more sensitive. If your pain comes when you bend over or apply pressure of the bottom part of your rib cage, you may have a fracture there. Rib fractures can hurt for weeks after the injury, which would explain your pain. You should ask your physician to evaluate whether you might have a broken rib. A final possibility is that you have injured your abdominal wall or chest wall musculature, either with a tear or some bleeding into the muscle itself. These musculoskeletal injuries are usually not serious, but can take a while for the pain to resolve. NSAIDs, like Ibuprofen or Aleve, can be useful to control pain and reduce the local inflammatory response. It is not possible to diagnose the cause of your discomfort without your seeing a doctor. Your pain may be entirely normal, but the fact that it is not improving with time means that you should arrange for an appointment in the near future. You can start out by seeing your primary care doctor, who can decide which, if any, further tests are appropriate for you.

This answer is for general informational purposes only and is not a substitute for professional medical advice.

If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.