Enlarged Spleen : symptoms, causes, risk factors and complications

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spleen pain causes

The spleen is organ which is located just below the left rib cage. There are many conditions, such as liver disease and some cancers, which can cause an enlarged spleen and this is also known as splenomegaly. The enlarged spleen usually is not causing symptoms [1]. This condition is often discovered during a routine physical exam. Your doctor cannot feel a normal – sized spleen in adults but if they have an enlarged spleen, then they can feel it. Your doctor will tell you to make blood tests and imaging to identify the cause for your enlarged spleen. The treatment of the enlarged spleen is focusing on the underlying condition which is the cause for it. In the most cases, surgery is not the first thing which doctors will do to their patients who have spleen issues but in some cases it can be recommended. The spleen is tucked under the rib cage next to the stomach on the left side of the abdomen. This is a soft and spongy organ which is performing several critical jobs. The functions of spleen are next:

  • The spleen stores red blood cells and platelets which can help your body to clot
  • The spleen filters out and destroys the old and damaged blood cells
  • The spleen is preventing infections by its ability to produce lymphocytes (white blood cells) and it is acting as a first line of defense against disease – causing organisms

The enlarged spleen can affect some of the mentioned vital functions of this organ. When your spleen grows larger, then it filters the normal red blood cells as well as the abnormal ones which is reducing the number of healthy cells in the bloodstream. This traps too many platelets. When you have excess red blood cells and platelets, then it can clog your spleen and this can affect the normal functioning [2]. The enlarged spleen can outgrow its own blood supply and this can damage or destroy the sections of this organ.

ruptured spleen

Symptoms of Enlarged Spleen 

If you have enlarged spleen, then it can cause:

  • Easy bleeding
  • Frequent infections
  • Fatigue
  • Anemia
  • Feeling full without eating or after eating only a small amount from the enlarged spleen pressing on your stomach
  • Fullness or pain in the left upper abdomen that may spread to the left shoulder
  • No symptoms in some cases

If you have pain in your left abdomen, especially if the pain is severe or the pain gets worse when you are taking a deep breath, then you should talk with your doctor as soon as possible.

Causes of Enlarged Spleen 

There are many diseases and infections which can cause enlarged spleen. The enlargement of the spleen can be temporary which depends on the treatment. Here are some factors that could lead to enlarged spleen:

  • Pressure on the veins in the spleen or liver or a blood clot in these veins
  • Metabolic disorders, such as Niemann – Pick disease and Gaucher’s disease
  • Blood cancers, such as leukemia and myeloproliferative neoplasms and lymphomas, such as Hodgkin’s disease
  • Various types of hemolytic anemia – a condition which is characterized by early destruction of red blood cells
  • Cirrhosis and other diseases affecting the liver
  • Parasitic infections, such as malaria
  • Bacterial infections, such as syphilis or an infection of your heart’s inner lining (it is known as endocarditis)
  • Viral infections, such as mononucleosis

Risk factors of Spleen

Everyone can develop an enlarged spleen on any age [1] but there are some factors which are increasing the risk of it [3], such as

  • People who live or travel to areas where malaria is common [4]
  • People who have Niemann – Pick disease and Gaucher’s disease, and several other metabolic disorders that are affecting the liver and spleen
  • Children and young adults with infections, such as mononucleosis

Complications of Enlarged Spleen

Here are some potential complications of enlarged spleen:

  • Ruptured spleen:

    People who have healthy spleen can be easily damaged because the healthy spleen is soft and easily damaged, especially in car crashes [5]. When your spleen is enlarged, then the possibility of rupture is increased. The ruptured spleen cause life – threatening bleeding in the abdominal cavity.

  • Infection:

    The enlarged spleen can reduce the number of healthy red blood cells, platelets and white blood cells in the bloodstream which can lead to more frequent infections [2]. Also increased bleeding and anemia are possible.

References:

[1] Chow KU, Luxembourg B, Seifried E, Bonig H. Spleen size is significantly influenced by body height and sex: Establishment of normal values for spleen size at US with a cohort of
1200 healthy individuals. Radiology. 2016;279(1):306-13.

[2] Pivkin IV, Peng Z, Karniadakis GE, et al. Biomechanics of red blood cells in human spleen and consequences for physiology and disease. Proceedings of the National Academy of Sciences of the United States of America. 2016;113(28):7804-9.

[3] Knapton S. Nomadic divers evolve larger spleens to stay underwater for 13 minutes, scientists find. The Telegraph. 2018.

[4] Whittle H, Gelfand M, Sampson E, et al. Enlarged livers and spleens in an area endemic for malaria and schistosomiasis. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1969;63(3):353-61.

[5] Frampton R, Lenard J. An in-depth study of abdominal injuries sustained by car occupants in frontal crashes. Association for the Advancement of Automotive Medicine. 2012;56:137-49.

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