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What is an Enlarged Spleen?

Douglas Bonderud
Douglas Bonderud

An enlarged spleen, known formally as splenomegaly, is a medical condition in which a person or animal’s spleen increases in size due to some sort of inflammation or other problem. The swelling doesn’t usually cause any immediate symptoms or pain, and as such people aren’t usually aware of what’s going on. If left untreated it can be very dangerous, though. Most enlargements are a consequence or side effect of some larger, often more serious condition, commonly infection, anemia, or blood cancer. In some of these cases the spleen acts as a sort of diagnostic marker that can prompt early treatment and, in many cases, a better outcome. There isn’t usually a specific course of treatment to reduce swelling of this organ on a universal level. Health care providers usually focus on curing or managing the underlying condition first, then wait for the spleen to respond.

Spleen Basics

Symptoms of an enlarged spleen may include feelings of fullness after consuming only a small amount of food.
Symptoms of an enlarged spleen may include feelings of fullness after consuming only a small amount of food.

The spleen is a small, fist-shaped organ that sits just below the ribcage on the left side of the body in humans and many animals. Its main job is to filter and process blood, and it also plays a role in the immune system by helping to shuttle white blood cells through the appropriate and needed pathways.

Is it very rare for the spleen to simply enlarge or become swollen all on its own. Most of the time, growth is a consequence of some sort of problem with the blood that is passing through the organ. A person who is beginning to develop some other infection or disease may not feel any direct physical symptoms for a while, but the problem is almost always immediately apparent in the blood. The spleen’s role in processing and filtering blood means that it is often one of the first organs directly impacted. Health care providers often try to feel patients’ abdomens during routine physical exams in part to detect enlargements that might indicate the need to do more tests.

Main Causes

Symptoms of an enlarged spleen may include pain on the left side.
Symptoms of an enlarged spleen may include pain on the left side.

There are many different possible causes for splenomegaly. Some of the most common include viruses, such as mononucleosis; leukemia and other blood cancers; and bacterial infections, such as syphilis. Trauma is another possibility. Even a healthy spleen is a soft organ, prone to severe damage if crushed or hit directly, as can happen in car accidents, assault cases, and otherwise. If an enlarged spleen ruptures, it could cause massive bleeding in the abdominal cavity, which can be fatal.

Common Symptoms

Blood tests may be performed to diagnose an enlarged spleen.
Blood tests may be performed to diagnose an enlarged spleen.

People with spleen enlargements don’t always have immediate symptoms, and many have no idea about the problem, particularly in its early stages. If symptoms do exist, they may include pain in the left side and extending up to the left shoulder, or a feeling of being full after only eating a small amount. This second symptom is caused by the oversized organ pushing on the stomach and limiting its storage space. Splenomegaly can be found by doctors during a physical exam, when they palpitate that area of the body. X-rays and blood tests are typically used to confirm the diagnosis and to get to the root of the problem.

Health Risks

Internal organs, including the spleen, which is located to the left of the stomach.
Internal organs, including the spleen, which is located to the left of the stomach.

In most cases, an enlarged spleen isn’t a condition that will simply fix itself. If left untreated, it can actually pose a number of serious health problems. One of the main functions of the spleen is to filter out old or damaged blood cells, but as it grows to too large, it begins to filter new and healthy blood cells as well. This sets up a repeating cycle in which the spleen grows larger the more red blood cells it filters. Also, the spleen can begin to consume platelets, which are necessary for blood to clot. If the problem is severe, a patient could be in real danger of bleeding to death from even a minor wound.

Treatment and Prognosis

If an enlarged spleen does not respond to non-invasive treatment, surgery may be necessary.
If an enlarged spleen does not respond to non-invasive treatment, surgery may be necessary.

Treatments for an enlarged spleen are generally directed to the underlying condition. In cases where the cause of the problem cannot be managed or the disease is recurrent, doctors may recommend a splenectomy, the removal of the spleen. People can usually survive without their spleen, but they are usually much more susceptible to infections since the spleen both produces and maintains white blood cells, which are essential to fight disease. Another option for some patients is the use of radiation to shrink the spleen; however, the long-term effect of radiation on the organ is not fully known. As such, this course of action is usually reserved for extreme situations.

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    • Symptoms of an enlarged spleen may include feelings of fullness after consuming only a small amount of food.
      By: berc
      Symptoms of an enlarged spleen may include feelings of fullness after consuming only a small amount of food.
    • Symptoms of an enlarged spleen may include pain on the left side.
      By: staras
      Symptoms of an enlarged spleen may include pain on the left side.
    • Blood tests may be performed to diagnose an enlarged spleen.
      By: science photo
      Blood tests may be performed to diagnose an enlarged spleen.
    • Internal organs, including the spleen, which is located to the left of the stomach.
      By: adimas
      Internal organs, including the spleen, which is located to the left of the stomach.
    • If an enlarged spleen does not respond to non-invasive treatment, surgery may be necessary.
      By: derege
      If an enlarged spleen does not respond to non-invasive treatment, surgery may be necessary.
    • An X-ray of the abdomen may be used to confirm the diagnosis of an enlarged spleen.
      By: alkerk
      An X-ray of the abdomen may be used to confirm the diagnosis of an enlarged spleen.