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

• Tumors or fluid-filled sacs (cysts).
• Disorders that affect your metabolism, 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.
• Unexplained weight loss.
• Feeling tired.
• Long-term (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. A piece of tissue is taken from the liver or bone marrow. The tissue is tested in the lab. This is done only 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.
• Being given blood (transfusion).

If these treatments do not help or if the cause cannot be found, surgery to remove the spleen (splenectomy) may be recommended.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your provider.
• If you were prescribed antibiotics, take them as told by your provider. Do not stop using the antibiotic even if you start to feel better.
• Talk with your 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 provider about limiting your activities. To avoid injury or a spleen that bursts (ruptures), make sure you:
  • Avoid contact sports.
  • Wear a seat belt in the car.

Contact a health care provider if:

• Your symptoms do not improve as expected.
• You have a fever or chills.
• You feel very weak.
• You have increased pain when you take a breath.
• You have cold and clammy skin or sweating for no reason.

Get help right away if:

• You experience an injury or impact to the spleen area.
• You feel dizzy or you faint.
• You have abdominal pain that becomes severe.
• You have chest pain or difficulty breathing.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.