The spleen, a fist-sized organ located in the upper left abdomen beneath the ribcage, is part of the body’s lymphatic and immune systems. It filters blood, removing old or damaged blood cells and producing white blood cells to combat infections. An enlarged spleen, medically termed splenomegaly, means the organ is larger than normal. This enlargement is not a disease itself but a sign of an underlying medical condition. While a healthy spleen measures up to 12 centimeters and weighs around 70 grams, an enlarged spleen can reach 20 centimeters and exceed 1,000 grams.
Recognizing the Symptoms
An enlarged spleen may not always present noticeable symptoms and is sometimes discovered during routine physical examinations. When symptoms do occur, they often involve discomfort or pain in the upper left side of the abdomen. This pain can sometimes extend to the left shoulder. Discomfort arises because the enlarged spleen may press against nearby organs, including the stomach.
Pressure on the stomach can lead to a feeling of fullness even after consuming small amounts of food, known as early satiety. An enlarged spleen can also affect blood cell counts. It might reduce healthy red blood cells, leading to anemia symptoms like fatigue and weakness. A decrease in white blood cells can result in more frequent infections, while reduced platelet counts may cause easy bleeding or bruising. Jaundice, characterized by yellowing of the skin or eyes, may also be present.
Common Causes of an Enlarged Spleen
Various underlying conditions can lead to an enlarged spleen, often due to the spleen’s increased workload in filtering blood or fighting off disease. Infections are a frequent cause, including viral infections like mononucleosis, bacterial infections such as endocarditis or syphilis, and parasitic infections like malaria. These infections can cause the spleen to overproduce immune cells, leading to its enlargement.
Liver diseases are another common contributor, particularly conditions like cirrhosis or portal hypertension. When pressure builds up in blood vessels connected to the liver and spleen, blood can pool in the spleen, causing it to swell. Blood cancers, including leukemias and lymphomas, can also result in an enlarged spleen as abnormal cancer cells infiltrate and multiply within the organ.
Certain metabolic disorders, such as Gaucher disease and Niemann-Pick disease, can cause substances to accumulate in the spleen. Autoimmune conditions like lupus or sarcoidosis may also contribute to spleen enlargement due to an overactive immune response. In rare instances, a blood clot blocking vessels in the liver or spleen can cause blood to build up and enlarge the spleen.
When to Seek Medical Care
If you experience persistent or severe pain in the upper left side of your abdomen, consult a healthcare professional. Other symptoms that warrant medical attention include unexplained fatigue, feeling full quickly after eating, or any other concerning changes in your health. These symptoms could indicate an enlarged spleen or another underlying condition requiring diagnosis.
Immediate medical attention is necessary if you experience sharp, sudden pain in the upper left abdomen that worsens with deep breaths. This type of pain could signal a ruptured spleen, which is a medical emergency. While a ruptured spleen can occur from trauma, an enlarged spleen is more susceptible to rupture, requiring prompt evaluation.
Medical Confirmation of an Enlarged Spleen
To confirm an enlarged spleen, a doctor typically begins with a physical examination. They will gently palpate the upper left side of your abdomen to determine if the spleen is enlarged, as a normal-sized spleen is usually not palpable in adults. This examination helps assess the spleen’s size and tenderness.
Following the physical exam, blood tests are often ordered. A complete blood count (CBC) can check for abnormalities in red blood cells, white blood cells, and platelets, which might indicate issues related to spleen function or underlying conditions. Liver function tests may also be conducted to assess liver health, given its connection to spleen enlargement.
Imaging tests play a role in confirming splenomegaly and determining its extent. An abdominal ultrasound is frequently the initial diagnostic imaging choice due to its effectiveness and non-invasive nature. Computed tomography (CT) scans and magnetic resonance imaging (MRI) can provide more detailed views of the spleen’s size, its relationship to other organs, and blood flow. These imaging modalities help identify any lesions or other contributing factors to the enlargement. Further specialized tests, such as a bone marrow analysis, may be performed to identify the root cause once an enlarged spleen is confirmed.