Definition and Overview

The spleen is a small fist-sized organ located on the left side of the abdomen. It is close to the stomach and pancreas, the organ that produces insulin, a hormone that regulates blood sugar. It is protected by the rib cage, so it’s not immediately felt when touched.

The spleen is part of the immune system since it also stores and produces white blood cells, which help fight threats such as bacteria and viruses that can cause infections such as meningitis and pneumonia, as well as other diseases. It regulates the production of platelets, a type of blood cell that is essential for blood clotting. The spleen can also store platelets and is also a part of the lymphatic system and therefore assists in the regulation of fluids in the body.

Spleen has the ability to filter the red blood cells. Composed of many blood vessels (which cause its purple color), the organ filters the red blood cells as they pass through it. The old or damaged ones are broken down but try to salvage whatever component it deems useful such as oxygen.

The spleen itself can become diseased or damaged usually due to accidents. When this happens, the doctor assesses whether the spleen can still be medicated or saved. Otherwise, it will be removed. Once it’s out of the body, the vital functions of the organ are passed on to the liver.

Causes of Condition

Below are some of the most common spleen problems and their possible causes:

  • Splenomegaly – This is another term for an enlarged spleen. Some of the most common reasons are infections caused by viruses, bacteria, and parasites. Cancers and conditions that affect the blood and/or the lymphatic system can also lead to this condition. Inflammatory diseases such as rheumatoid arthritis are also linked to the abnormal size of the spleen. Sometimes it grows when it accumulates abscess or develops a cyst (non-benign tumor).

  • Ruptured spleen – A ruptured spleen is breakage of the organ. It can be described as lacerated, which means only a part of the organ is torn or damaged. Either way, it needs immediate medical attention since it may lead to internal bleeding and shock. One of the most common causes of a ruptured spleen are accidents, particularly vehicle collision.

  • Hypersplenism – It’s a term to describe an overactive spleen. It may filter the red blood cells prematurely. It can be linked to lymphatic cancers, inflammatory diseases, cirrhosis of the liver, and malaria.

  • Splenic sequestration – This is a medical condition associated with sickle cell disease, an inherited blood disorder characterized by the presence of abnormal-shaped, sickle-cell-looking red blood cells. Since these cells are easily and quickly broken down, there may not be enough oxygen supply in the blood, resulting in anemia. The sickle cells can also accumulate in the spleen as the red blood cells are filtered, leading to an enlarged spleen and poor function of the organ.

  • Accessory spleen – An accessory spleen is an extra spleen. It doesn’t have any function and thus can be removed without adverse effect.

  • Thrombocytopenia – A condition where there’s not enough platelet in the bloodstream as the spleen tries to hold on to most of it.

  • Asplenia – a condition wherein the spleen doesn’t function normally. It’s also possible the person doesn’t have a spleen, but it’s rare.

Key Symptoms

  • Anemia
  • Fatigue
  • Muscle weakness
  • Easy bruising
  • Swelling of the lymph nodes
  • Feeling of being full quickly despite eating only small amounts
  • Pain in the spleen area
  • Chronic, frequent, or recurrent infections
  • Easy bleeding
  • Stomach pain
  • Jaundice (yellowish color of the skin usually due to liver damage or sickle cell disease)
  • Lightheadedness
  • Disorientation or confusion
  • Swelling of the hands and feet

Who to See and Treatments Available

An internist for adults and pediatrician for children can already diagnose spleen problems. If it is blood-related, a hematologist may become part of the team. If it affects the lymphatic system, an immunologist, a specialist in the immune system, is the best doctor. In cases of a ruptured spleen, an emergency doctor can attend to the patient.

Below are the different ways to diagnose a spleen problem:

  • Physical exam – The doctor feels the spleen by pressing gently into the left side of the abdomen near the rib cage. If it can be felt, the spleen may then be enlarged.

  • Ultrasound – An ultrasound is a good way to find out the size of the spleen.

  • Blood tests – These may be requested if the doctor suspects the spleen problem is connected to infections or blood-related disorders. An abnormality of any of the blood ranges, especially if the difference is significant or large, requires an investigation.

  • Imaging tests – Usually, an imaging test such as an MRI or a CT scan is not necessary especially as an enlarged spleen can already be felt. But it may be helpful to assess further the extent of the damage to the spleen.

If it’s a ruptured spleen and it’s an emergency, usually the best step is to undergo surgery. The tear or laceration may be repaired, or the entire spleen may be removed in a procedure known as splenectomy through laparoscopy. In this process, small incisions are made on the left side of the abdomen; and using a laparoscope, a kind of probe with an illumination and a camera, the doctor locates the spleen, uses the live feed as a guide, and operates using small surgical tools. This procedure is preferred since it is less invasive and surgical risks such as infections are minimal.

If the spleen problem is connected to another condition such as an infection or a blood disorder, treating the underlying cause will also resolve it.

Reference:

  • Nemours Foundation: "Spleen and Lymphatic System."
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