Enlarged Spleen

Just below your left rib cage is where your spleen is located. An enlarged spleen can be brought on by a variety of illnesses, such as infections, liver disease, and some types of cancer. Splenomegaly is another name for an oversize spleen.

Symptoms of splenic enlargement are uncommon. It is frequently found during a normal physical examination. In adults, the spleen is often not palpable unless it is enormous. Finding the reason for an enlarged spleen might be assisted by imaging and blood testing.

The cause of an enlarged spleen will determine the course of treatment. In most cases, surgery to remove an enlarged spleen is unnecessary, however, it may occasionally be advised.

Enlarged Spleen: Causes

An enlarged spleen can be brought on by a variety of illnesses and infections. Depending on the therapy, the enlargement can only be brief. Among the contributing elements are −

• Viral illnesses, including mononucleosis

• Illnesses caused by bacteria, including syphilis or an infection of the lining of the heart (endocarditis)

• Parasitic diseases like malaria

• Cirrhosis and other liver-related illnesses

• Different forms of hemolytic anemia, which is defined by the early breakdown of red blood cells

• Leukemia, myeloproliferative neoplasms, and lymphomas including Hodgkin's disease are examples of blood malignancies.

• Metabolic diseases like Niemann-Pick disease and Gaucher disease

• Splenic or hepatic vein pressure, or a blood clot in these veins

• Autoimmune diseases like lupus and sarcoidosis

The Function of the Spleen

On the left side of your abdomen, behind your ribs, and close to your stomach, is where your spleen is located. Generally speaking, its size depends on your height, weight, and sex.

This pliable, flexible organ serves a variety of vital functions, including −

• Removing and eliminating damaged, aging blood cells

• Generating white blood cells (lymphocytes), which serve as the initial line of defense against disease-causing pathogens, and preventing infection.

• Preserving the platelets and red blood cells that aid in blood clotting

Each of these occupations is affected by an enlarged spleen. Your spleen may not function normally if it is enlarged.

Enlarged Spleen: Symptoms

The patient with an enlarged spleen mainly presents with the following symptoms that include −

• Left upper belly pain or heaviness that may radiate to the left shoulder

• The spleen presses against your stomach, causing you to feel full even after eating only a tiny quantity or without eating at all.

• Red blood cell shortage (anemia)

• Many infections

• Readily bleeding

When to Visit a Doctor?

If you experience discomfort in your left upper abdomen, especially if it is severe or worsens with deep breaths, consult a doctor right once.

The following issues might arise from an enlarged spleen −

• Infection. Infections may occur more frequently if your circulation has less healthy red blood cells, platelets, and white blood cells due to an enlarged spleen. Furthermore conceivable are anemia and accelerated bleeding.

• Damaged spleen. Spleens may be readily damaged, even when healthy, especially in vehicle accidents. When your spleen is big, there is a considerably higher chance of rupture. A burst spleen can result in life-threatening abdominal hemorrhage.

Enlarged Spleen: Risk Factors

Several factors play an important role in the development of an enlarged spleen which includes −

Anybody can acquire an enlarged spleen at any age, however, some populations are more susceptible, such as −

• Infections in children and adolescents, such as mononucleosis

• The liver and spleen are affected by Gaucher disease, Niemann-Pick disease, and various other hereditary metabolic illnesses.

• Those who reside in or visit malaria-prone regions

Enlarged Spleen: Diagnosis

The diagnosis of the enlarged spleen is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

• Blood tests to measure your system's red blood cell, white blood cell, and platelet counts as well as your liver's function

• To assess the size of your spleen and if it is obstructing other organs, get an ultrasound or CT scan.

• To monitor splenic blood flow using MRI

Discovering the Root Cause

Occasionally further testing, such as a bone marrow biopsy examination, is required to determine the reason for an enlarged spleen.

A process known as a bone marrow biopsy allows for the removal of a sample of solid bone marrow. A bone marrow aspiration, which removes the liquid portion of your marrow, is another option. Both treatments might be carried out simultaneously.

Enlarged Spleen: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Therapy for enlarged spleen hinges on what's causing it. For instance, antibiotics may be used as therapy if you have a bacterial illness.

Attentive waiting − Your doctor may advise cautious waiting if you have an enlarged spleen but no symptoms and the cause cannot be determined. If you experience symptoms, you should schedule a follow-up appointment with your doctor within 6 to 12 months.

Surgical Treatment

Surgery to remove the spleen. Splenectomy surgery may be an option if an enlarged spleen produces major consequences or if the reason cannot be found or cured. The best chance for healing in chronic or serious conditions may come through surgery.

Careful thinking is required before elective splenectomy. While it is possible to live an active life without a spleen, doing so increases your risk of developing serious, potentially fatal infections.

After splenectomy, doing the following actions can help lower your risk of infection −

• Before and after the splenectomy, a series of vaccinations. They include meningococcal, Haemophilus influenzae type b (Hib), and pneumococcal (Pneumovax 23) vaccinations, which guard against meningitis, pneumonia, and infections of the blood, bones, and joints.

• After surgery, you'll also require the pneumococcal vaccination every five years.

• Following surgery and each time you or your doctor suspect an infection. Using penicillin or other medications.

Enlarged Spleen: Prevention

To lower the chance of a burst spleen, stay away from contact sports like soccer, football, and hockey and restrict other activities as directed. Furthermore crucial is the use of a seat belt. A seat belt can help protect your spleen in a vehicle collision.

Conclusion

An interprofessional team that comprises a radiologist, internist, hematologist, oncologist, surgeon, nursing staff, and occasionally additional specialists including rheumatologists and gastroenterologists is the best option for treating patients with splenomegaly. Patient education is essential since there is a significant chance of rupture, and contact sports should be avoided by splenomegaly patients.

The patient should be informed by the nursing staff that having a splenectomy increases their risk of infection. Before the splenectomy, vaccination against encapsulated organisms is strongly advised. Every splenectomy patient should wear a medical alert bracelet that describes their condition and the reason for their lack of a spleen. In post-splenectomy patients having surgical treatments, antibiotic prophylaxis is advised.