Enlarged Spleen (Splenomegaly)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Steven Doerr, MD
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
- What is the spleen, and what is its function?
- What does the spleen look like, and where is it located in the body?
- What are the causes of an enlarged spleen?
- What type of pain, and where is the pain located with an enlarged spleen?
- What are other signs and symptoms of an enlarged spleen?
- How is the diagnosis of an enlarged spleen made?
- What is the treatment for an enlarged spleen?
- What complications are associated with an enlarged spleen?
- Can an enlarged spleen be prevented?
- What is the prognosis for someone with an enlarged spleen?
- Patient Comments: Enlarged Spleen - Cause
- Patient Comments: Enlarged Spleen - Symptoms
- Patient Comments: Enlarged Spleen - Treatment
What is the spleen, and what is its function?
The spleen is an important organ in the body that has a variety of responsibilities.
- It is a major filter of blood, helping remove old and damaged red blood cells, and bacteria.
- It also part of the lymphatic system and produces lymphocytes, a type of white blood cell that is part of the immune system that helps prevent and fight infection.
- The spleen also acts as a reservoir for red blood cells and platelets, should the body need them.
What does the spleen look like, and where is it located in the body?
The spleen is located in the left upper quadrant of the abdomen, just beneath the diaphragm and next to the stomach. It has a very rich blood supply since it is responsible for filtering blood, and it is protected by the 9th, 10th, and 11th ribs. Normally, it is the size of an orange or a small fist.
The spleen has two types of tissue; the red pulp is responsible for filtering blood, while the white pulp is responsible for its immune function.
What are the causes of an enlarged spleen?
The spleen will enlarge when it performs more of its duties to filter blood or to manufacture blood cells. Therefore, any disease or condition that damages red blood cells, and requires them to be filtered and removed from the blood stream, will cause the spleen to become larger.
Conditions such as hemolytic anemia, where red blood cells are damaged and broken down (hemolyzed) can cause the spleen to enlarge. Misshapen red blood cells, like those produced in sickle cell anemia, thalassemia, and spherocytosis; may not be able to maneuver through small capillary blood vessels and then become damaged. The damaged cells need to be culled and filtered by the spleen.
Decreased blood flow
The spleen will enlarge if there is a decrease in blood flow through the splenic vein. This may cause spleen congestion and enlargement. This situation may be associated with liver disease and portal hypertension. Damage to liver cells makes it difficult for blood to flow normally, and as blood backs up in the portal vein system, it may also affect pressure in the splenic vein. This increased pressure decreases blood draining from the spleen and causes it to become congested and larger. People with congestive heart failure may have an enlarged liver and spleen because of poor blood flow to and from the heart.
Leukemia and lymphoma may be associated with abnormal white cells that can invade the spleen and increase its size.
Certain metabolic diseases may cause the spleen to enlarge, including Hurler Syndrome, Gaucher Disease and Niemann-Pick Disease.
Some viral infections may cause splenomegaly including:
- Infectious mononucleosis caused by the Epstein-Barr virus
- Viral hepatitis
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