Although injuries to the spleen are not an every day occurance after a car crash, they are not rare either. Trauma to the spleen can occur, and it does not always manifest itself immediately. In fact, sometimes the symptoms of an injury to the spleen do not become apparent until days after an accident.
From a recent case I handled: a woman is rear ended in a high speed crash. She's taken to the ER, has normal vital signs, and is in no apparent distress. She's treated and released for a neck and back sprain and goes home to recuperate from her various sprains.
The next day, she's running errands with her daughter. She starts to feel “very fidgety and uncomfortable.” She then begins to develop a radiating pain from her abdomen up through her left shoulder. She becomes nauseous and sweaty, and is taken back to the ER.
The ER doctor examines her and notes that she has a positive Kerr's Sign: abdominal and distinct left shoulder pain, two of the hallmark signs of a ruptured spleen. Why is it called a "Kerr's Sign?" Because, most likely, some dude named Dr. Kerr discovered this in 1911 or 1935 or whatever and named the test after himself. But I digress...
The ER doc immediately orders a CT Scan, which confirms a Grade III tear of the spleen. According to medical literature, spleen lacerations are graded on a scale of 1-5, and a Grade III laceration, for example, involves more than 50% of the surface area of the spleen, and a laceration of greater than 3 cm in depth.
What does it mean to have a Grade III laceration? You're going to be hospitalized for a few days to make sure the laceration starts to heal, and if it does not, you're looking at a splenectomy (removal of the spleen). Removal or not, you're in for a lengthy convelescence and not much strenuous activity (like exercise) for months in order to avoid re-injuring it.
The takeaway? If you get a sudden onset of abdominal and shoulder pain a day or two after a motor vehicle collision, get yourself to the ER, and don't assume it's par for the course. It may save you from a serious problem down the road--a slowly bleeding spleen. I'm no doctor, but I do know that bleeding vital organs are generally not a good thing....and I didn't even stay at a Holiday Inn Express last night (as the commercial goes)...