Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Enlarged Spleen?
Enlarged spleen is medically termed as Splenomegaly. It is an enlargement of the spleen that is often associated with any disease that involves an aberration in the red blood cells. The incidence is believed to be in response to hyperfunction in order to compensate for the rapid breakdown in the red blood cells.
Splenomegaly can affect people from all age level and without racial and sexual predilection. Older adults on the other hand are more prone for enlarged spleen owing to the normal aging process where spleen is subject to thinning with increase weight and size and thus, potential for splenic injury and trauma.
Spleen is a tiny organ about the size of a fist and is located in the peritoneal cavity particularly in the right upper quadrant. It is housed and protected by the rib cage and the average weight is about 200g and size is about 11cm in length in healthy adults. The function of this organ is vital to sustain a healthy functioning of the body system. Spleen functions in filtering blood and removing byproducts of red blood cells breakdown including other materials and particles that can pass through the blood vessels. Spleen also functions in helping the immune system by synthesizing lymphocytes.
Symptoms of an Enlarged Spleen
Generally, spleen is not palpable except for some individuals who have slimmer body or those with remarkable coastal margin. A palpable spleen however, does not necessarily mean it is enlarged or a manifestation of any clinical implication.
Splenomegaly is often asymptomatic and can be recognized with routine checkup often due to other underlying medical condition. In cases where symptoms may manifest, these may include the following:
Pain or fullness can be felt on the left upper part of the abdomen. The symptom of pain is the result of an enlarged spleen pressing and irritating the diaphragm and the irritation often leads to pain radiating to the left shoulder.
Loss of appetite is also experienced including feeling of fullness even with small feeding. This symptom is the result also of diaphragm being pressed on by enlarging spleen.
Other symptoms also include the following:
- Weakness and fatigue
- Frequent bouts of infection
- Uncomplicated bleeding resulting from diminished platelets or from recurrent infection
- Distention and bleeding of the abdomen resulting from damaged spleen after it has rupture from enlargement
The signs and symptoms mentioned should not be disregarded and medical attention should be considered to prevent further complication and danger of ruptured spleen.
Splenomegaly is also classified according to degree of enlargement. Moderate splenomegaly is identified with an enlargement of spleen in about 11 to 20cm in dimension. Extreme splenomegaly is described with a dimension of more than 20cm in dimension and with a presentation of palpable spleen that can extend to the pelvis or across the midline of the abdomen. Caudal displacement of gastric bubble is also audible with abdominal percussion in extreme case of splenomegaly.
Spleen is a diverse organ that involves most of the vital organs and their functions in the body system. The association in numerous body organs makes the spleen prone to enlargement as an effect of many disorders and abnormalities of multiple organs associated with it. Malfunction in blood cells from an array of factors can trigger the spleen to work overload to compensate in the synthesis of red blood cells.
Various diseases and conditions can result to spleen enlargement and these may include the following:
Bacterial and viral infection is the primary source of spleen enlargement as the spleen is driven to work in excess to respond to the need in warding off infection. The most common source of infection that leads to splenomegaly is from an Epstein bar virus causing infectious mononucleosis. Bacterial infection from syphilis is another factor contributing to enlargement of the spleen.
Splenic vein pressure
Splenic vein pressure results to inflammation of the spleen when the abnormal blood that passed through the splenic artery is unable to leave through the splenic vein as it becomes blocked.
Haemolytic anemia is also a contributory factor in the spleen enlargement and is often due to early breakdown in red blood cells while the spleen is working overload to compensate for the function of filtering during the process of red blood cells breakdown.
Other factors include diseases and disorders affecting the liver including metabolic disorders and blood disorder.
Enlargement of spleen is managed through treatment of underlying condition contributing to the incidence. Thorough diagnosis and identification is necessary prior to treatment for prompt and effective management of reducing the spleen enlargement. An antibiotic is usually prescribed for splenomegaly resulting from infection.
Surgical removal of the spleen is an option if the underlying condition cannot be identified and if enlargement persist after various treatment has been applied. Spleen removal on the other is carefully considered due to the drawback after the procedure which can make the patient prone to other serious infection which can be life-threatening. The overall prognosis for splenomegaly however, is excellent while morbidity is not directly from the enlargement but from the underlying condition in which it has stemmed.