Enlarged Spleen

An enlarged spleen (splenomegaly) is when the spleen is larger than normal. The spleen is an organ that is located in the upper left area of the abdomen, just under the ribs. The spleen is like a storage unit for red blood cells, and it also works to filter and clean the blood. It destroys cells that are damaged or worn out. The spleen is also important for fighting disease.

This condition is usually noticed when the spleen is almost twice its normal size. An enlarged spleen is usually a sign of another health problem.

What are the causes?

• Mononucleosis and other viral infections.
• Infection with certain bacteria or parasites.
• Liver failure and other liver diseases.
• Blood diseases, such as hemolytic anemia.
• Blood cancers, such as leukemia or Hodgkin's disease.

• Tumors and fluid-filled sacs (cysts).
• Metabolic disorders, such as Gaucher disease or Niemann–Pick disease.
• Pressure or blood clots in the veins of the spleen.
• Connective tissue disorders, such as lupus or rheumatoid arthritis.

What are the signs or symptoms?

• Pain in the upper left part of the abdomen. The pain may spread to the left shoulder or get worse when you take a breath.
• Feeling full without eating or after eating only a small amount.
• Feeling tired.
• Chronic infections.
• Bleeding or bruising easily.

In some cases, there are no symptoms.

How is this diagnosed?

• A physical exam. Your health care provider will feel the left upper part of your abdomen.
• Tests, such as:
  • Blood tests to check red and white blood cells and other proteins and enzymes.
  • A biopsy. During a biopsy, a tissue sample of the liver or bone marrow may be removed and looked at under a microscope. A biopsy may be done if there is concern that the liver or bone marrow is causing the enlarged spleen.
  • An abdominal ultrasound.
  • A CT scan.
  • An MRI.

How is this treated?

• Manage the conditions that cause enlargement of the spleen.
• Reduce the size of the spleen.

• Medicines to treat infection or disease.
• Radiation therapy.
• Blood transfusions.

If these treatments do not help or if the cause cannot be found, surgery to remove the spleen (splenectomy) may be recommended. After surgery, you may need to have vaccinations or take antibiotics to prevent infections.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Talk with your health care provider about whether you need vaccinations to help prevent infections. This may be needed if treatment included surgery to remove the spleen. Not having a spleen makes certain infections more dangerous because it weakens the body's disease-fighting system (immune system).

General instructions

• Follow instructions from your health care provider about limiting your activities. To avoid injury or a ruptured spleen, make sure you:
  • Avoid contact sports.
  • Wear a seat belt in the car.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your symptoms do not improve as expected.
• You have a fever or chills.
• You feel generally ill.
• You have increased pain when you take in a breath.

Get help right away if you:

• Experience an injury or impact to the spleen area.
• Have abdominal pain that becomes severe.
• Feel dizzy or you faint.
• Feel very weak.
• Have cold and clammy skin.
• Have sweating for no reason.
• Have chest pain or difficulty breathing.

Summary

• An enlarged spleen (splenomegaly) is when the spleen is larger than normal.
• An enlarged spleen is usually a sign of another health problem.
• This condition is treated with medicines, radiation therapy, blood transfusions, vaccines, or surgery.