What Is The Spleen?

The spleen is part of the lymphatic system. In fact, it is the largest of the lymphatic organs. Located in the upper left portion of the abdomen, it performs the vital function of filtering blood by removing dead or worn out red cells and metabolizing the hemoglobin contained in them.

It also produces certain antibodies and clears away dead cells, bacteria and foreign substances from the blood. The spleen holds in reserve a small amount of blood that can be released in times of need. Hence, this organ plays an important part in maintaining immunity and balance within the body.

What Is An Enlarged Spleen?

Sometimes, usually on account of disease, the spleen becomes abnormally enlarged. This condition is known as a splenomegaly. It could arise when the spleen has been overworked, filtering the blood, removing bacteria and dead cells.
This tends to happen when the body is fighting an infection. It could also happen in the instance of leukemia or lymphoma, both of which are malignancies of the blood.

The human spleen is a small organ and comparable in size to a closed fist. Generally, it cannot be felt upon palpation of the abdomen. If the spleen is clearly noticeable upon palpation, this means that it has undergone significant enlargement and swelling. However, this is only a rough guideline and will need to be confirmed by formal diagnostic procedures and laboratory tests.

A person is said to be suffering from mild splenomegaly if the organ swells to the extent that it weighs between 400 and 500gm. Any more than 1000gm in weight indicates severe spleen enlargement. Such a highly enlarged spleen is at risk of becoming ruptured which can occur as a consequence of trauma to the abdominal region.

Why Does This Happen?

There can be a number of factors responsible for the enlargement of the spleen. Infectious diseases, liver diseases, and blood cancers can all cause the spleen to become abnormally distended. Often, splenomegaly arises as a consequence of conditions that cause the spleen to work too hard.

For instance, when a person is suffering from a bacterial infection, the immune response of the body manages to deactivate bacteria in large numbers. But it also suffers casualties in the form of dead white blood cells. This puts a greater burden than usual on the spleen whose function it is to isolate this material from the blood and keep the blood clean.

A similar principle applies when a person is suffering from blood cancer. Malignant cells are different from normal blood corpuscles. The spleen identifies them and removes them in large quantities, causing the organ itself to become distended.

There can be a range of other causes as well, including inflammation due to autoimmune activity and congestion on account of liver disease. The list below covers some conditions that could potentially give rise to enlargement of the spleen:

Infections including viral diseases such as infectious mononucleosis, bacterial infections such as syphilis, tuberculosis, and endocarditis as well as infectious parasitic diseases such as malaria and schistosomiasis.

Liver disease such as cirrhosis, viral hepatitis, cystic fibrosis and portal hypertension.
Anemia associated with conditions like hereditary spherocytosis, thalassemia and sickle cell disease.
Metabolic disorders such as Gaucher disease and amyloidosis.

Tumors in the spleen or those that have extended to the spleen from other locations.
Cysts in the spleen.
Trauma to the spleen.
Heart failure.

Cancers including the various types of leukemias, lymphomas, and polycythemia vera.
Myeloproliferative disorders such as myelofibrosis.
Vascular conditions such as obstruction of the hepatic vein, portal vein or the splenic vein.
Autoimmune disorders like rheumatoid arthritis and systemic lupus erythematosus.
Certain medications or drugs.

What Are The Symptoms Of An Enlarged Spleen?

Not every patient with spleen enlargement will necessarily notice any significant symptoms. Those that might appear are generally nonspecific and do not clearly indicate a problem with the spleen.

The list below outlines some symptoms:

A sensation of fullness in the upper abdomen.
This may be accompanied by pain in the upper abdomen or the area of the back corresponding to the location of the spleen.
Feeling full without having eaten much. This happens because the distended spleen is putting pressure on the stomach.
Feeling tired.
Shortness of breath.

What Are Some Potential Complications?

This section briefly addresses some risks that should be kept in mind with regard to splenomegaly:

Anemia: When the spleen becomes excessively distended, it can destroy far more red blood cells that it should. The resulting deficit of healthy red blood cells leads to anemia which leaves the patient feeling weak and short of breath.

More frequent infections: Reduced numbers of white blood cells leave the body unable to fight infection.
Frequent bleeding: Platelet counts can drop drastically, lowering the ability of blood to coagulate when required.

Splenic rupture: A swollen spleen can become ruptured by application of force on the abdomen. This can occur when playing contact sports or even by sustaining a fall.

Patients who have already been diagnosed with an enlarged spleen should take care to avoid situations that could potentially lead to splenic rupture as this can be a critical condition.

Bleeding and death of tissue: When the spleen becomes severely enlarged, the blood supply that it normally receives becomes insufficient for the maintenance of the enlarged organ. As a result, parts of the enlarged spleen may bleed and even die.

How Can It Be Diagnosed And Treated?

Since an enlarged spleen does not generally produce many clearly identifiable symptoms, a doctor may have to rely on other symptoms related to the underlying cause of the problem. For instance, if fever is present, this points to an infectious process.

The following procedures can aid in making a diagnosis:

Physical examination.
Medical history.
Blood and urine tests for signs of metabolic disorders, anemias, blood cancers or infection.
Imaging tests such as X-rays, computerized tomography (CT) and magnetic resonance imaging (MRI).
Liver function tests.
Tissue biopsy. If, for example, myeloproliferative disorders are suspected, samples of bone marrow may be obtained for biopsy. Obtaining tissue from the spleen itself is not generally viable unless the organ has been surgically removed.

Other, more specialized, tests may be ordered depending on specific findings that come to light through the diagnostic procedures listed above. Treatment is dependent on the final diagnosis.

Bacterial infections can be effectively cleared up by means of antibiotics. Antiviral medications are prescribed for viral infections. Radiation therapy can help to bring down the enlargement of the spleen in some cases. In extreme instances, doctors may advise complete surgical removal of the enlarged spleen by means of a procedure known as splenectomy.

Conclusions:

Splenomegaly or enlarged spleen is fairly common since it can develop as a result of some common infectious diseases. It can affect individuals of any age. In fact, it is common for young children since they are rather susceptible to infections.

When the condition is severe enough to warrant surgical intervention for the removal of the enlarged organ, patients must take care thereafter to protect themselves from infections. This can be done by making sure to take vaccines as prescribed by their doctor.