Shreyas Iyer's spleen injury: How would a normal fall cause it? Doctor explains

It looked like just another catch-and-fall to many on TV. But, when cricketer Shreyas Iyer writhed with pain after taking the catch that dismissed Australia's Alex Carey during the third One-Day International match between India and Australia in Sydney, a few days ago, onlookers wondered why. When the eventual reports mentioned that he suffered a life-threatening ribcage injury and was in the ICU, most questions on social media were those of disbelief.

Apparently, Shreyas even fainted in the dressing room after the fall, his vitals dropped to scary levels, and he was immediately rushed to the hospital. The 30-year-old's scans revealed he had a laceration injury to his spleen. Internal bleeding was also detected, and his recovery period is expected to extend longer than what was predicted earlier. 

An organ of the lymphatic system, the spleen helps store and filter blood and fight infection. It is located in the upper left abdomen. Dr H Ramesh, Senior Consultant, Director of Surgical Gastroenterology at VPS Lakeshore Hospital, Kochi, explains how a fall that looked quite ordinary could have led to such a spleen injury .

What is a laceration injury to the spleen?
While spleen injury is not common among cricketers, it is among those who do contact sports like rugby and American football, says Dr Ramesh. "The spleen injury is also widespread in road accidents. Our rib cage protects the spleen for the most part.  In the past, most spleen injuries required surgery. Today, they are managed without surgery, as we have better monitoring and intensive care systems," he says.

If the injury passes through the spleen, or if the spleen is shattered, fractured across the middle, or the main blood vessels are damaged, surgery can be required to remove it. In most cases, however, patients with injuries confined to one end of the spleen, or those with a blood clot within the spleen caused by a contusion, can be managed without surgery, the doctor says. As for laceration injuries, he explains that they can be of many types. "Lacerations can vary in type and severity. A CT scan helps determine whether the injury is through and through, and if there is extravasation — leakage of blood from the vascular system — which may require surgery. If there is no active bleeding, it usually stops in some time," he says. 

How could the fall have caused the spleen injury?
It looks like a part of Shreyas' arm was stuck under his body, and he landed awkwardly, the doctor says. "This may have driven the force directly into his rib cage. There may be a rib fracture, though it’s not confirmed in the reports. It’s quite common to have at least one rib broken in such cases — that’s how the spleen often gets injured," Dr Ramesh observes. 

Does recovery take long?
Dr Ramesh says that, generally, recovery can take about 6 weeks. "Many sportsmen who experience this injury come back to the sport in a few weeks," says the doctor. 
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