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ENLARGED SPLEEN

The spleen is the lymphoid organ located in the upper left part of the abdomen towards the back. It is an important part of the immune system as it filters the blood by removing defective blood cells from the bloodstream and produces the white blood cells that fight against diseases. Enlarged spleen, also called “splenomegaly” is a condition in which the size of the spleen is increased. It is not a disease but indicates underlying conditions such as infections, liver disease, and some cancers.

 

If the enlarged spleen is left untreated, it may lead to severe complications such as infections and a ruptured spleen, which causes severe bleeding that can be fatal.

 

Causes

Various disease conditions cause enlargement of the spleen. Usually, the size of the spleen increases when it works excessively, especially during any condition that damages blood cells, requires the blood to be filtered, and the abnormal blood cells are to be removed.

 

The common causes of enlarged spleen are:

 

  • Bacterial infections such as syphilis or endocarditis
  • Large abscess or pus-filled cavity which is usually caused by bacterial infection
  • Viral infections such as cytomegalovirus and mononucleosis
  • Parasitic infections such as toxoplasmosis, malaria
  • Inflammatory diseases such as lupus, rheumatoid arthritis
  • Cirrhosis and other liver disorders
  • Hemolytic anemia
  • Blood cancers
  • Cancer that has spread to the spleen
  • Metabolic disorders such as Gaucher's disease
  • Trauma

 

Risk factors

The risk of enlarged spleen is more in children and patients with mononucleosis. People who travel or live in areas where malaria is common are also at increased risk. People with certain disease conditions such as Gaucher’s disease, Niemann-Pick disease, and other inherited metabolic disorders affecting the liver and spleen are also at increased risk of developing enlarged spleen.

Symptoms

The symptoms of enlarged spleen are very rare and hence the condition is diagnosed during physical examination. However, few symptoms such as inability to eat larger meal, feeling discomfort while eating, and pain in the abdomen that spreads to the left shoulder are usually seen. Do not ignore and meet the doctor immediately.

An enlarged spleen develops the following signs and symptoms which are related to underlying disease conditions:

 

  • Feeling of fullness
  • Fatigue
  • Easy bleeding
  • Reduced immunity or frequent infections
  • Shortness of breath
  • Weight loss
  • Paleness
  • Night sweats

 

Diagnosis

An enlarged spleen is usually detected during a physical examination, i.e., by palpating the left upper abdomen. However, the diagnosis is confirmed only after performing the following tests:

 

  • Blood tests: it includes a complete blood count that helps determine the number of red blood cells, platelets, and white blood cells
  • Computed tomography (CT) scan or ultrasound:  this test helps to determine the size of your spleen
  • Magnetic resonance imaging (MRI): this test helps to check the blood flow through the spleen.

 

Treatment

The treatment usually depends on the underlying condition that is responsible for spleen enlargement. If it is diagnosed causing no symptoms, visit the doctor for reevaluation for every six months or immediately after experiencing the symptoms. Other treatment options include:

 

  • Splenectomy: The splenectomy is the surgical removal of your spleen. However, the removal spleen may not affect your body functions.
  • Radiation therapy: Sometimes, radiation therapy would be an effective approach and best alternative to surgery. Radiation therapy causes the spleen to shrink and reduce the symptoms.
  • Medications: Vaccines and medications are given when removal of spleen does not effectively clear the bacteria.

 

Self-management and prevention

 

Patients with an enlarged spleen should completely avoid contact sports such as football, hockey, and soccer. Wearing a seat belt would be beneficial as it prevents the spleen damage when there is an accident.

 

The patients should be vaccinated against the infections caused by the Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitides as the surgical removal of spleen increases the risk of infections.

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