Springbok lock Eben Etzebeth has been ruled out of Saturday's Test against Italy after sustaining a heavy head blow against England at Twickenham last weekend.

England No 8 Billy Vunipola clashed heavily with Etzebeth late in the first half, which saw the Bok bruiser forced out of the remainder of the match. England won 37-21.

Bok coach Allister Coetzee confirmed that the 54-cap veteran would miss the match against Italy but that he was still in the frame to play against Wales on November 26.

"Eben hasn't done his full protocols yet but he has been presenting symptoms [of concussion]," Coetzee said. "Hopefully he will begin his protocols on Tuesday [today]. He had nausea, but that has subsided although he is still having a few headaches. It's a five-day process.

"He is definitely out of the match against Italy but he will stay with the squad because he could be ready for the following week.

"Pieter-Steph [du Toit] will move back to lock with Lood de Jager and we still have Franco Mostert in the squad. We won't fly another player out because Uzair Cassiem from the Cheetahs has also joined us."

Coetzee does have a small selection headache, though, because De Jager is suffering from bruising on the thigh while Du Toit is nursing a lot of bumps and bruises from the Twickenham battle. De Jager, though, declared that he would be ready by Saturday.

"I'm available for the weekend, I just have a bit of a contusion on my quad and we are monitoring [that] with the doctor, but I'm confident I'll be ready," De Jager said.