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What is Splenomegaly?

By S. Gonzales
Updated Feb 20, 2024
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Splenomegaly is a medical condition in which the spleen becomes enlarged. Causes for splenomegaly may include infections, blood cancers, liver diseases, and metabolic disorders, or even undue pressure on the liver and spleen's veins or blood clots in those veins. Specific diseases that may cause the condition include mononucleosis, syphilis, Hodgkin's disease, Gaucher's disease, and Niemann-Pick disease. Splenomegaly can effect people of all ages and, as symptoms of splenomegaly usually don't present themselves, the condition can remain undetected until a physician conducts a general physical exam.

The spleen is located on the left upper quadrant of the abdomen, just below the rib cage. Amongst its various functions, the spleen removes and destroys blood cells that are old or have been damaged, accumulates blood and platelets that aid in clotting, and prevents infections by creating white blood cells to combat pathogens. Any or all of these functions can be compromised when the spleen becomes enlarged through splenomegaly.

A normal spleen is usually as big as a human fist. When splenomegaly occurs, it can cause significant changes in the organ's function and can even result in the partial destruction of it. For example, an enlarged spleen means that normal-functioning, as well as old and damaged, blood cells will be removed from the spleen. This means that the availability of healthy blood cells in a person's bloodstream will be reduced.

If splenomegaly is suspected, a physician may order blood tests or imaging like an ultrasound, a computerized tomography (CT) scan or magnetic resonance imagining (MRI) to confirm a diagnoses. In cases where causes are difficult to determine, specialized tests like a bone marrow exam or liver function tests may be performed. Some patients, however, may experience symptoms associated with splenomegaly. Those may include anemia, recurring or frequent infections, easy bleeding, and pain that radiates from the left upper abdomen to the shoulder. People who experience pain that is frequent, severe, or made worse through breathing should visit a doctor immediately, as this may indicate a ruptured spleen which can be potentially life-threatening.

Splenomegaly is treated by first addressing the underlying conditions that encouraged the spleen to enlarge. For example, antibiotics may be prescribed to those fighting infections and chemotherapy or radiation may be administered to patients who suffer from Hodgkin's disease. By treating the underlying condition, it is hoped that the spleen will return to its normal size. Surgery for removing an enlarged spleen is sometimes recommended, though it is usually a last resort.

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Discussion Comments
By pleonasm — On Aug 22, 2011

@croydon - It's a bad idea to think of the procedure where they remove your spleen as being trivial. People can and do die from the lack of a spleen, particularly if they take its functions for granted.

Of course, if all you had was a moderate splenomegaly, you were probably not in any danger of losing it.

Doctors try to keep a little bit of spleen in place now if they can, just because there is no real replacement for it. And if you do have it removed, you need to take medications to ensure that your immune system continues to work properly.

It might never affect you, but if it did, you could quickly be in serious trouble. So it's better to be safe than sorry.

In fact, for some people, the doctors pretty much just make them take antibiotics for years in order to make sure they will be OK without a spleen.

By croydon — On Aug 21, 2011

The spleen is one of those things that you just don't think about until something goes wrong with it.

At one point I was having some pain and the doctor was a bit worried that I was having splenomegaly symptoms, and I researched the worse case scenarios such as spleen removal. Even though it does quite a few different things in the body, it doesn't seem to be all that essential.

They followed a few people who had their spleen removed over a number of years and mostly they just seemed to be slightly more likely to die of pneumonia.

So, I guess that made me feel a bit better about it, although it turned out that I didn't need to do it after all.

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