Ruptured Mass on the Spleen

By January 10, 2012 July 14th, 2012 Interesting Cases

‘Shilo’ is an 11 year old, neutered male, Labrador Retriever who was presented to us for lethargy and vomiting. He had been panting excessively overnight, and didn’t seem to be his usual, energetic self.

On his physical examination, Shilo’s mucous membranes (gums) were pale, and blood loss was suspected. An abdominocentesis (drawing fluid out of the abdomen with a needle) was performed, and blood was aspirated. This indicates bleeding within the abdominal cavity.

Bleeding in the abdominal cavity may be due to trauma, ulceration or perforation of the intestines, or a rupture of one of the abdominal organs. Radiographs (x-rays) of the abdomen were taken, and a large mass was visible. It was suspected that the mass was on the spleen.

Due to the fact that free blood was found in the abdomen, indicating that the mass had ruptured, an emergency, exploratory laparotomy (abdominal surgery) was recommended in order to identify the problem, stop the bleeding, and potentially remove/repair the affected organ. During surgery, a large mass was identified on one end of the spleen. The mass had grown to such a large size that it had ruptured, and was the source of the bleeding. The veins and arteries going to and from the spleen were ligated (tied off with suture material) and the entire spleen was removed. Shilo recovered well from surgery, and was able to go home to his family after a couple of days recovering in hospital.

This is an image of Shilo's spleen after being removed. Note the large irregular area on the left side, which is the spot where it ruptured!








Good news – the histopathology report on the spleen came back and the mass was non-cancerous! Under microscopic evaluation, the pathologists found it to be a hematoma (a collection or pocket of blood outside of a blood vessel) and removal should be curative!

The spleen is an abdominal organ that resides just below the stomach, and towards the left side of the body. It is attached to the stomach by a ligament. The main functions of the spleen are to make and store red blood cells, remove old, nonfunctional red blood cells from the circulation, and also provide some immune system activities. Because of the storage of blood in the spleen, if a mass forms and ruptures (such as in Shilo), a significant amount of bleeding may occur, and may be fatal if not dealt with immediately. Masses may form due to neoplasia or cancer (e.g. hemangiosarcoma, lymphoma, etc), or may be benign or non-cancerous (e.g. hematoma or hemangioma). The only way to determine whether or not a mass is cancerous is to send a biopsy (piece of the affected tissue) to a pathologist, to examine under a microscope and determine the types of cells that are within the tissue. Luckily for Shilo (and his family!), his mass was benign, and he has been given a clean bill of health!