Mononucleosis infection causes acute splenic enlargement which also makes the organ more susceptible to rupture from trauma. Mononucleosis is often transmitted via oral mucosa in activities such as sharing water-bottles or kissing.
Blunt injury to the spleen is the most common cause of death for visceral injury. The liver and kidney are also commonly injured organs during sporting events. Splenic injuries may present with nausea and vomiting, sometimes pain referred to the shoulder (Kehr's sign), prior to the development of hypotension and collapse. Injury to the kidney may present with or without blood in the urine. Diagnosis is made with abdominal CT which can also evaluate the liver, kidneys, and bowel. Treatment ranges from observation to immediate laparotomy and packing and/or splenectomy.
Green reviews GI disorders that are seen in athletes, specifically those that are amenable to medical management. They remind the reader that the athletic performance can not only exacerbate but also mask an underlying GI disorder, and therefore any complaints of abdominal pain should be viewed both within and outside of the context of sports.
1) Regular creatine usage does not cause splenic enlargement.
2) Spider bites can cause skin necrosis but not splenic enlargement.
3) Drinking alcohol does not place the spleen at increased risk for injury.
5) Taking NSAIDS on an empty stomach can cause gastric irritation and abdominal pain but not splenic enlargement/rupture.
Green GA. Gastrointestinal disorders in the athlete. Clin Sports Med 1992;11:453-470
PMID:1591796 (Link to Abstract)
Kibler WB (ed): ACSM’s Handbook for Team Physician. Philadelphia, PA, Williams & Wilkins, 1996, p 151