Where are these organs located in the body?
The spleen is on the left side of the tummy, under the ribcage.
The liver is on the right side of the tummy, under the ribcage, on top of the stomach, right kidney and intestines.
The kidneys are located towards the back, one on either side of the spine, below the ribcage.
What causes these injuries?
Spleen, liver or kidney injury can occur when there has been trauma to the area of the tummy where these organs are located. In kids, this may happen after a car, bicycle or skateboard crash, following a fall from a height, during contact sports, or after an awkward fall. A knock to the tummy can cause a bruise or a cut within the organ causing it to bleed. With Kidney injury, there is also risk of urine leaking and collecting around the kidney.
Symptoms of abdominal organ injury:
- Tummy pain or back pain
- Pain across the shoulders
- Looking pale, and sleepy
- Feeling dizzy
- Nausea or vomiting
- Pink or red urine meaning blood is in the urine
Please go to the nearest Emergency Department if your child displays any of the above symptoms following a knock to the tummy.
How are these injuries diagnosed?
Injuries to these organs can be difficult to notice at first, especially if there is no bruising to the tummy, and the blood pressure is normal.
In the Emergency Department, an ultrasound can be used to see if there is fluid in your child’s tummy; this is called a FAST scan
If injury to one of these organs is suspected, your child may then need a computerized tomography scan (CT scan). Any injury found to one of these organs is usually given a grade – from grade 1 (low, mild) to grade 5 (high, serious).
How are these injuries treated?
Your child will be admitted to hospital. The treatment and length of stay will depend on how serious the injury is. Most children with injuries to these organs are treated with a drip, pain medication, rest, restricted diet, breathing exercises and sometimes a urine catheter may be needed.
Your child will be monitored closely and require regular blood tests to see how the injured organ is functioning and if it is still bleeding or not. Blood pressure monitoring will detect high blood pressure, which can happen after kidney injury.
It is rare for a child with an injury to the spleen, liver and/or kidney to need an operation. However, your doctor will discuss this with you, if necessary.
The doctor will decide when you can take your child home, depending on their level of pain and discomfort, if they are eating and drinking and if they have done a poo.
Care at home
You will be given specific discharge instructions with advice on pain relief and safe level of activity.
Activities should be gentle, such as board games, walks, craft and some screen time. This means, no wrestling, rough play, climbing, jumping on the bed or any physical activity that could lead to a hit in the abdomen.
When can my child return to school?
Your child should rest at home until they are feeling back to normal. They can usually return to school 1-2 weeks after the injury. It is important to check with your child's doctor first.
When can my child return to sports?
Your child should not return to sport, bike riding, skateboards, trampolines and high impact activities until your doctor gives the go-ahead. This will usually be 1-2 months after the injury, but may be longer for more severe injuries. This is because the risk of getting knocked in the tummy again, while still healing, is high.
You will be given specific discharge instructions detailing returning to sports.
The Trauma Nurses will call you 2 weeks after you have gone home to follow up.
In some cases, you may need to attend a follow up appointment for a progress check or scan 4-6 weeks later, but you will be told before going home.
Following a kidney injury, your child may need to have their blood pressure checked at the GP for some time after being discharged from the hospital.
If any of the following symptoms occur after your child goes home, please return to the Emergency Department or call an Ambulance (000):
- Increasing pain
- Pale or dizzy
- Worsening shoulder pain
- Jaundice (yellowing of skin/eyes)
- Blood in the urine, stool or vomit
- Further injury to the abdomen
- Most injuries to the spleen, liver or kidney settle down without the need for an operation. A period of time in hospital and a quiet few weeks will help ensure a full recovery.
- It is important to follow your discharge instructions including rest periods and gentle activity to allow the organ to fully heal and reduce the chance of bleeding starting up again.