Mononucleosis is a viral infection that can create dangerous circumstances within the spleen. Most individuals diagnosed with this illness are told to avoid contact sports and strenuous activity due to the fact that during its course, it can cause the spleen to swell multiple times its normal size (DerSarkissian, 2016). During the infection, the spleen, an organ involved in storing and educating lymphocytes, is highly active with a high volume of blood in order to fight off the virus. This swelling also thins the spleen’s surrounding capsule, making it more susceptible to major injury (Bjerke, 2014).
If the spleen is damaged, it can cause severe internal bleeding in the abdominal cavity. The spleen is highly vascularized and is thought to filter 10-15% of a person’s blood every minute. The spleen can also store a reserve of 40-50 mL of red blood cells and 25% of an individual’s circulating platelets (Bjerke, 2014). Because of this, the spleen itself doesn’t have much of its own structure. It’s often thought to be a “bag of blood” (Hough, 2016), which illustrates why a rupture or laceration could be so dangerous.
Splenic damage can have a highly variable clinical presentation across individuals. The most common sensation is abdominal tenderness in the upper left quadrant of the abdomen. If internal bleeding results in blood loss of more than 5-10% of the total blood volume, the patient may begin to enter into early shock, which usually presents as tachycardia, anxiety, and restlessness. If the bleeding continues, the patient’s sympathetic nervous system may go into overdrive, causing the patient to go into overt shock. This blood loss can also cause pallor of the skin, decreased capillary refill, and decreased pul...
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...tissue death. When this is felt during damage to the spleen, visceral afferents are stimulated. The afferent fibers run alongside sympathetic fibers to the spinal cord. Here, they enter the T6-T8 region of the spinal cord via the dorsal roots along with somatic sensory fibers. Therefore, the area illustrated in figure 1 likely contains the somatic sensory fibers that run to T6-T8. When the signal is sent to the brain, the brain can’t determine whether the signal is coming from the visceral afferents or the somatic sensory fibers, so it sends a signal that both have pain (Hough, 2016).
In this situation, the player, teammates, and coach should be informed of the dangers of the situation and discouraged from allowing the player to play in the game. Officials should also be notified to ensure that they are keeping their best eye out for rough play, fouls, and penalties.
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