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Kansas City Chiefs explain how they discovered Alex Smith's lacerated spleen

Here is the full statement and Q&A from Kansas City Chiefs head trainer Rick Burkholder on the lacerated spleen suffered by Alex Smith on this hit in the Steelers game. This transcript comes courtesy of the Chiefs.

Charles LeClaire-USA TODAY Sports

BURKHOLDER: "I just want to give you guys an update. Since I’ve been here for two years, since Coach (Reid) has been here and Alex (Smith) has been here, and John (Dorsey) has been here, we’ve been very transparent about what goes on injury-wise so we are at another situation with the Chiefs where we have to tell you guys about an injury.

So in the Pittsburgh game early in the third quarter, Alex took a shot to his abdomen and he subsequently has a lacerated spleen. And so he will not play this week. It’s a non-surgical case. It will heal on its own, but he is going to have to have some time down from contacts and collisions. So with that in mind, let me walk you through where we went from Sunday to last night when we had a final diagnosis. So Sunday early in the third quarter, he threw a ball down the field to Albert Wilson and was hit in the abdomen. When I reviewed it on tape with Alex, it looks like as normal as can be, a fairly normal hit that he takes. I didn’t even notice it during the game. In fact, the only questions I asked him during the game and after the ballgame were whether his knee was alright because he took the shot below the knee. And he said he was alright.

But then as we were clearing out the training room in Pittsburgh, he came in and asked Dr. (Mike) Monaco, our team internist, and Dr. Luke Thompson from KU to take a look at his abdomen because he had taken a pretty good shot. As I walk you through this I will try to tell you what we look for for spleen injuries. We had no idea at the time so what you look for is you look for increased tenderness in the four quadrants of his spleen in his upper left quadrant. And he really didn’t have any pain there the day of the game. And you look for tenderness throughout his abdomen and a fullness in his abdomen. With a spleen injury, you also look to see whether he has this urge to have a bowl movement and also late manifestations are left arm pain. All this is because of bleeding so as the spleen bleeds – a very vascular organ, it’s really a big lymph node – it will bleed and then cause all this pain in his abdomen and then into his left arm.

The reason Alex didn’t have any symptoms Sunday that tipped us off were he didn’t bleed very much. So we went Monday, came in here and worked out, he did fine. Orthopedically, doing Coach (Barry) Rubin’s work out and running, he was fine. On Tuesday, we practiced, if you remember it was a little bit different schedule. He came in right after lunch and said, ‘I just don’t feel quite right’. If you remember back to the last couple weeks, we’ve had a couple guys with a gastrointestinal virus. So we had guys miss all last week. So we weren’t sure if he was getting sick or not. Dr. Thompson was in the building, he took a look at him. We got a urine sample on him to see whether anything was showing up. Nothing was showing up, he wasn’t getting worse, but he wasn’t getting better either. I had him see Dr. Monaco on Wednesday morning and Dr. Monaco walked him through everything, examined him and everything checked out. He encouraged Alex, if things didn’t get better, to go get a scan of his belly just to see what was going on. We weren’t sure whether it was viral or whether it was actually the hit that he took.

So Wednesday afternoon after practice, which was Christmas Eve, obviously our coaches and Alex and the quarterbacks were still working. He wanted to wait until Christmas Day, which was an off day for the players, somewhat. He was going to do Christmas with his family and then in the afternoon we were going to check with him and see whether he wanted to do the scan over at KU, which Alex will walk you through this part. Initially he didn’t want to do it. Dr. Monaco and him exchanged some interesting text messages and Alex decided to do it at Dr. Monaco’s urging.

So last night we got the diagnosis through the scan that he had about a three centimeter laceration in his spleen and he didn’t have hardly any bleeding at all. So we referred him to Dr. Michael Moncure at The University of Kansas Hospital who is a trauma surgeon, he reviewed the study, drew blood on him. He determined that his spleen was slightly enlarged and that he has a small laceration. From a long-term standpoint and from a health stand-point for Alex, he’s going to be fine. That’s going to heal up. We will continue to try to decide why his spleen is a little enlarged, it may just be him. It could be from the trauma. But we are doing a little bit more studies just because we cover ourselves that way and we cover him and make sure that we are on point. The problem is that its contra indicated to play with a lacerated spleen, even one that’s probably a little less than three centimeters. You can’t do it and the reason being is if you would take another shot there and the laceration would increase, then you have a medical emergency because that’s a very vascular organ and it can bleed and all that.

My hat goes off to Alex for his toughness. Also, we live on top of each other here and we all have a close relationship and he kept in constant communication with me and with the doctors. Dr. Moncure said last night, this is a 1-in-100 find for our doctors because he didn’t have any signs of a spleen. But they just have what I call blink, so Dr. Monaco has a blink where he says, ‘something’s not right’. I’ll take you back to the Eric Berry thing where Dr. Barnthouse (said) something’s not right. So you get the study and I won’t go as far as to say that we saved a life but you saved something that could go on Sunday. In this league with our medical staff we are lifeguards and we are supposed to do player safety. I think my group of docs, through KU and through Dr. Barnthouse and Dr. Monaco, do as good a job as anybody in the league protecting these players."

Q: What is the recovery timeline and long-term outlook with this?

BURKHOLDER: "Generally these things, now he’s got a small laceration, generally they take 6 weeks, but everybody is different. He is a young healthy guy that has got a high metabolism so if we are playing three or four weeks from now, we will rescan him and see where he is at and send him back to the general surgeon and confer with Dr. Monaco and any doctors that Alex wants to, to see if he can play. But like I said, generally they take six weeks to heal up, they are very vascular and they do fine."

Q: So long-term you aren’t expecting any health issues?

BURKHOLDER: "No, full recovery."

Q: So he would miss about six games if it were the beginning of the year?

BURKHOLDER: "Probably." Q: Or whatever goes on beyond that? BURKHOLDER: "Exactly, he’s out right now."

Q: So the Super Bowl?

BURKHOLDER: "Well the Super Bowl is six weeks from the time he got hurt. Does he heal up faster? I hope we have that problem."

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