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Enlarged Spleen (Splenomegaly)

Definition


Disease: Enlarged Spleen (Splenomegaly) Enlarged Spleen (Splenomegaly)
Category: Digestive diseases

Disease Definition:

Just below the rib cage on the left side, there’s the spleen, which is a small organ, usually about the size of a fist. A number of conditions could cause the spleen to enlarge (splenomegaly), such as infections, liver disease or some cancers.

 

An enlarged spleen is usually discovered during a routine physical exam, and most people don’t even have signs or symptoms. The cause of an enlarged spleen could be determined by imaging and blood tests.

 

Relieving the underlying condition is what treatment for an enlarged spleen focuses on. In some situations, surgically removing an enlarged spleen could be an option; however, it won’t be a first choice.
 

Work Group:


Symptoms, Causes

Symptoms:

Usually, an enlarged spleen doesn’t cause any signs or symptoms, however, in some cases, people could experience some of these signs and symptoms:

 

  • Fatigue
  • Anemia
  • Easy bleeding
  • Frequent infections
  • Pain in the left upper abdomen that may spread to the left shoulder
  • Feeling full without eating or after eating only a small amount. This occurs when an enlarged spleen presses on the stomach.

 

In case someone experiences pain in their left upper abdomen, particularly if it’s severe, or if it gets worse when taking a deep breath, they should promptly see a doctor.
 

Causes:

The spleen, which is a soft and spongy organ that performs several critical jobs, is located on the left side of the abdomen, tucked under the rib cage next to the stomach, it could be easily damaged. Some of the things that the spleen does are:

 

  • Filters out and destroys old and damaged blood cells
  • Stores blood and platelets, which are the cells that help the blood clot
  • Plays a key role in preventing infections by producing lymphocytes, which are white blood cells and acting as a first line of defense against invading pathogens.
  • May act as an intermediary between the immune system and the brain. A thing that led the researchers think that one day they may be able to trigger the spleen’s infection-fighting abilities by manipulating the nervous system.

 

When the spleen grows larger, it reduces the number of healthy cells in the bloodstream because it filters abnormal red blood cells along with normal ones. It also traps too many platelets. Eventually, excess blood cells and platelets clog the spleen and interfere with its normal functioning. Sections of the spleen could be damaged or destroyed because the spleen could outgrow its own blood supply. Some of the infections and diseases that could cause an enlarged spleen include:

 

  • Leukemia, Hodgkin’s disease or other blood cancers
  • Mononucleosis or other viral infections
  • Pressure on the veins in the spleen or liver or a blood clot in these veins
  • Malaria or other parasitic infections
  • Cirrhosis and other diseases affecting the liver
  • Gaucher’s disease, Niemann-Pick diseases, or other metabolic disorders
  • Syphilis, endocarditis or other bacterial infections.
  • Various types of hemolytic anemia, which is a condition that is characterized by premature destruction of red blood cells.
     

Complications

Complications:

A person may develop anemia, increased bleeding or frequent infections because an enlarged spleen can reduce the number of healthy red blood cells, platelets and white cells in the bloodstream. The risk of a ruptured spleen is more serious; even healthy spleens are soft and can easily get damaged, particularly in car crashes. However, the possibility of the spleen to rupture is far greater if it’s enlarged. When a spleen is ruptured, it could cause life-threatening bleeding into the abdominal cavity.
 

Treatments:

As mentioned before, relieving the underlying condition is what treatment for an enlarged spleen focuses on. Chemotherapy or radiation could help bring Hodgkin’s disease into remission, and antibiotics could be used to treat infections.

 

Surgical removal of the spleen, a procedure called splenectomy, could be an option in case the underlying problem can’t be identified or treated, or if the enlarged spleen is causing serious complications. Surgery may also be the best hope for recovery in chronic or critical cases.

 

However, elective spleen removal requires careful consideration. Although a person can live an active life without a spleen, however, they will be more likely to contract serious or in some cases life-threatening infections, such as overwhelming post-splenectomy infection, which usually occurs soon after the surgery. In some cases, when radiation shrinks the spleen, surgery can be avoided.

 

HOW TO REDUCE THE RISK OF INFECTION AFTER SURGERY:

There are some steps that a person could take in order to reduce the risk of infection after removing the spleen, such as:

 

  • Avoiding traveling to parts of the world where diseases such as malaria are endemic
  • Taking penicillin or other antibiotics after the surgery, sometimes for life.
  • Taking a series of vaccinations, both before and after the splenectomy, including haemophilus influenza type b (Hib), the pneumococcal (Pneumovax), and meningococcal vaccines that protect against meningitis, pneumonia and infections of the blood, joints and bones.
     

Prognosis:

Not available

Expert's opinion

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