Treatment for Liver or Spleen Injuries

The liver or spleen may be injured through sport accidents, a motor vehicle incident or during play, such as a fall from a monkey bar. At the time of the trauma, the liver or spleen may “crack” and have bleeding inside the organ, or the covering of the spleen or liver may tear, or rupture, resulting in bleeding inside the abdomen.

Signs and Symptoms

  • Pain on the right side of the abdomen or right shoulder may occur when the liver is injured
  • Pain on the left side of the abdomen or left shoulder may be present when the spleen is injured
  • Some children will hold the abdomen (stomach area) and complain of pain
  • The abdomen (stomach area) may feel firm when touched (known as "guarding")
  • Your child may be pale, dizzy or have a fast heart beat (pulse) if there is bleeding in the abdomen


When your child is brought to Mary Bridge Children’s Hospital after an injury, specialty physicians from the pediatric surgery team, Emergency Department, Pediatric Intensive Care Unit and inpatient pediatric team will all work together to diagnose and treat your child.

  • If an injury to the spleen or liver is suspected, a type of X-ray called computed tomography, or CT scan, will be requested
  • Blood tests will be done to look at the blood count and liver functions
  • Your child will also be examined for other possible injuries


We use a grading system to decide how badly your child’s liver or spleen is injured. This grade helps to determine treatment recommendations for your child. Most injuries will heal without surgery, but will require a hospital stay. Children with severe injuries may require admission to the Intensive Care Unit, but most children are admitted to a Medical/Surgical Unit.

Initial treatment in the hospital will include:

  • Bed rest
  • Heart rate and oxygen monitors
  • Blood count checks every eight to 12 hours until it remains stable

In some cases a blood transfusion may be required. We will discuss this with you in detail if your child needs one.

When will we go home?

  • One to five days after the injury, depending upon the grade or severity
  • After your child’s blood count does not decrease
  • When your child has minimal pain
  • The day after he or she is able to walk in the hospital

What may my child do when we go home?

Quiet activity should be planned for the first seven days with adult supervision.

When may my child return to play and sports?

When your child is discharged from the hospital, your surgeon will recommend when your child can start regular activity and contact sports. This may range from three to six weeks from when your child returns home. Your doctor may want a CT scan or ultrasound after discharge, before allowing your child to play contact sports.

Call Child Life Services at 253-403-5315 to schedule a pre-surgery tour.