The Sports Report: December 2, 2014

It’s been a busy week in sports, specifically football.

Eric Berry

First, Kansas City Chiefs safety Eric Berry, 25, was diagnosed with a mass in his chest. Berry had complained of chest discomfort at the end of the game against the Oakland Raiders. When the pain persisted the next day, and didn’t seem consistent with an orthopedic injury, an x-ray and MRI were performed, and the mass was found. Doctors were concerned that Berry may have a lymphoma, and was transferred to Emory Hospital in Atlanta to undergo testing to get a definitive diagnosis and begin treatment.

As of now, no specific diagnosis has been announced, and Berry is expected to be out the remainder of the season.

Lymphoma is the most common cancer cause of a  chest mass in young adult. There are two types of lymphoma: Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma (NHL). Hodgkin’s is more likely in young adults. NHL is more common in older adults (typically about 60 years old), but is possible in younger patients, as was the case of Spartacus actor Andrew Whitfield, who lost his battle with NHL in Sept 2011.

Rarer tumors, such as thymic tumors and thyroid cancer, and well as  tumors which have spread from other parts of the body are also possible.

We will return to this story when a final diagnosis is revealed.

Justin Hunter

Tennessee Titans wide receiver Justin Hunter (above) was hospitalized after he was hit in the stomach by Texans safety Danieal Manning. Although he returned to play, he continued to complain of stomach pain and was taken to the hospital. Teammate Nate Washington told the Tennessean:

“This is a situation where football goes out the window. He has internal bleeding. … Any time a guy is spitting up blood you have to be concerned. This is bigger than football. I just hope that everything is all right. … Justin is like a brother to me, and I want to make sure he is OK.”

Hunter was diagnosed as having a lacerated spleen. Fortunately, he has not required surgery and is expected to be released soon. It is unknown whether he will be playing again this season.

Splenic rupture

Splenic rupture, also known as a lacerated spleen, occurs when a significant impact to the spleen from some outside source (i.e. automobile accident, punch to the abdomen, etc) damages or ruptures the spleen.

spleen2The spleen is an organ above the stomach and under the ribs on the left side. It is about the size of your fist. The spleen is part of the lymphatic system, which fights infection and keeps your body fluids in balance. It contains white blood cells that fight germs. The spleen also helps control the amount of blood in the body, and destroys old and damaged cells. The soft pulp of the spleen is surrounded by a fibrous material called the capsule.

Splenic injury most often occurs in automobile accident victims, in which it is a leading cause of internal bleeding. However, any type of major impact directed to the spleen may cause splenic trauma. This can happen in bicycling accidents, when the handlebar is forced into the left rib margin. The degree of injury ranges from subcapsular hematoma- a collection of blood under the capsule , to splenic rupture where the capsule has been breached.

The main concern in any injury of the spleen is internal hemorrhage (bleeding). The amount of hemorrhage may be small or large, depending on the nature and degree of injury. Small or minor injuries can heal on their own and only require observation and support. Larger injuries can cause extensive bleeding, which can lead to hemorrhagic shock, and death.

Signs and symptoms of a ruptured spleen include:

  • Pain in the upper left portion of the abdomen
  • Tenderness when you touch the upper left portion of the abdomen
  • Lightheadedness
  • Confusion

The spleen, being a very vascular organ can be difficult to repair, and may need to be removed (partially or totally) if bleeding is severe. Although a person can live without a spleen, those without one are at greater risk for infection, and must be followed closely by a physician.

Kosta Karageorge

Finally, a sad story from Ohio State, where the body of missing football player Kosta Karageorge, 22, was found with a possibly self-inflicted gunshot wound.

Karageorge, 22, had been reported missing by his mother, after she received a disturbing text message from her son: “I am sorry if I am an embarrassment but these concussions have my head all f—– up.”

Karageorge was a wrestler at Ohio State for three years, and  he joined the football team this season as a walk-on defensive tackle. His wrestling coach, Tom Ryan, denied that he had any documented concussions while he was on the wrestling team. The football team also stated that Kosta had not played in any games this season.

An autopsy is being performed, and a neuropathologist will look for signs of traumatic brain injury.

Traumatic brain injuries are associated with a full range of short and long term outcomes– including physical, behavioral, cognitive and emotional problems. Recent research has demonstrated that major depression is estimated to occur in over half the cases of TBI!  Depression often coexists with other psychiatric conditions, such as addiction and anxiety.

Although more attention is paid to biologic triggers of depression after TBI, psychological triggers may be just as important, especially since not all TBI patients show x-ray or pathological evidence of TBI.

Depression can complicate the treatment for those with TBI, both in terms of response to therapy and in cooperation with treatment.

We await the autopsy results in what could be another cautionary tale of the price of head injuries in sports.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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