Enlarged Spleen

The spleen is an organ located in the upper abdomen under your left ribs. It is a spongelike organ, about the size of an orange, which acts as a filter. The spleen is part of the lymph system and filters the blood. It removes old blood cells and abnormal blood cells. It is also part of the immune response and helps fight infections. An enlarged spleen (splenomegaly) is usually noticed when it is almost twice its normal size.

CAUSES

There are many possible causes of an enlarged spleen. These causes include:

  • Infections (viral, bacterial, or parasitic).

  • Liver cirrhosis and other liver diseases.

  • Hemolytic anemia (types of anemia that lower your red blood cell count) and other blood diseases.

  • Hypersplenism (reduction in many types of blood cells by an enlarged spleen).

  • Blood cancers (leukemia, Hodgkin's disease).

  • Metabolic disorders (Gaucher's disease, Niemann-Pick disease).

  • Tumors and cysts.

  • Pressure or blood clots in the veins of the spleen.

  • Connective tissue disorders (lupus, rheumatoid arthritis with Felty's syndrome).

SYMPTOMS

An enlarged spleen may not always cause symptoms. If symptoms do occur, they may include:

  • Pain in the upper left abdomen (pain may spread to the left shoulder or get worse when you take a breath).

  • Feeling full without eating or eating only a small amount.

  • Feeling tired.

  • Chronic infections.

  • Bleeding easily.

DIAGNOSIS

Tests may include:

  • Physical examination of the left upper abdomen.

  • Blood tests to check red and white blood cells and other proteins and enzymes.

  • Imaging tests, such as abdominal ultrasonography, computerized X-ray scan (computed tomography, CT), and computerized magnetic scan (magnetic resonance imaging, MRI).

  • Taking a tissue sample (biopsy) of the liver to examine it.

  • Examining a bone marrow biopsy sample.

TREATMENT

Treatment varies depending on the cause of the enlarged spleen. Treatment aims to manage the conditions that cause swelling of the spleen and reduce the size of the spleen. Treatment may include:

  • Medications to eliminate infection or treat disease.

  • Radiation therapy.

  • Blood transfusions.

  • Vaccinations.

If these treatments are not successful, or the cause cannot be determined, surgery to remove the spleen (splenectomy) may be recommended.

HOME CARE INSTRUCTIONS

  • Take all medications as directed.

  • Take all antibiotics, even if you start to feel better. Discuss with your caregiver the use of a probiotic supplement to prevent stomach upset.

  • To avoid injury or a ruptured spleen:

  • Limit activities as directed.

  • Avoid contact sports.

  • Wear your seatbelt in the car.

  • See your caregiver for vaccinations, follow up examinations and testing as directed.

  • Follow all of your caregiver's instructions on managing the conditions that cause your enlarged spleen.

PREVENTION

It is not always possible to prevent an enlarged spleen. Reduce your chances of developing an enlarged spleen:

  • Practice good hygiene to prevent infection.

  • Get recommended vaccines to prevent infection.

SEEK MEDICAL CARE IF:

  • You develop a fever (more than 100.5°F [38.1° C]) or other signs of infection (chills, feeling unwell).

  • You experience injury or impact to the spleen area.

  • Your symptoms do not go away as you and your doctor expected.

  • You experience increased pain when you take in a breath.

  • Your symptoms worsen, or you develop new symptoms.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.

Follow up with your caregiver to find out the results of your tests. Not all test results may be available during your visit. If your test results are not back during the visit, make an appointment with your caregiver to find out the results. Do not assume everything is normal if you have not heard from your caregiver or the medical facility. It is important for you to follow up on all of your test results.