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The spleen is the organ of the human body, located just below the left rib cage in the top part of the abdomen towards the back. The spleen is the part of the lymph system and functions as a drainage section, which protects the body from various infections. The spleen has white blood cells, which take in bacteria, dead tissue, and any foreign substances, and remove them from the blood. It also helps to maintain a healthy ratio of white and red cells, as well as the platelet count. The spleen recycles iron in haemoglobin and filters antibody-coated bacteria.

The spleen is typically the size of a human fist but conditions such as infections, liver diseases, specific cancers, etc. can cause it to swell and increase multiple time in size. That said, an enlarged spleen is not always a cause of worry. Sometimes when a spleen becomes enlarged it might imply it has become overactive and is functioning at its full capability. This is referred to as hypersplenism.

However, in other conditions, where the enlarged spleen tends to press on the other organs, it can impact the blood flow to the spleen. This will, in turn, affect the capability of the spleen to filter blood properly. Also, if the spleen becomes too big, it can remove an excessive number of red blood cells from the body, which can lead to a medical condition known as anaemia. Furthermore, the enlarged spleen can cause the body to experience infections more than usual.

Symptoms of spleen enlargement

In many cases, an enlarged spleen or called splenomegaly, might not cause any symptoms. However, in other conditions, the problem can have the following symptoms:

  • Abrupt pain or a feeling of fullness in the abdomen (precisely the upper left part), which can spread to impact the left shoulder
  • Anaemia
  • Fatigue
  • More risk of bleeding
  • More risk of infections
  • Feeling more full than usual even after a small meal

However, if the pain in the upper left abdomen intensifies or there is no relief, the patient must be taken to a doctor at the earliest.

Causes of spleen enlargement

An enlarged spleen can be caused because of multiple infections and diseases. However, the condition can be temporary and mild or could be severe and cause a lot of symptoms. Some of the factors that can lead to enlargement of the spleen include:

  • Viral infections
  • Bacterial infections
  • Infection in the inside layer of the heart
  • Cirrhosis or other critical liver issues
  • Malaria or similar parasite-based infections
  • Blood cancers including leukaemia
  • Lymphomas
  • Disorders or issues with the metabolic functioning of the body
  • Medical conditions that destroy the red blood cells earlier than their expiry age
  • A blood clot in the veins
  • Strain on the veins of the spleen or liver

Risk factors of spleen enlargement

Spleen enlargement can occur at any age and in any gender. However, some people are at higher risk of developing this condition. These include:

  • Children and young age adults that suffer from infections such as mononucleosis
  • People with inherited metabolic issues that impact the spleen and liver, such as Niemann-Pick disease
  • People who are more exposed to places where malaria is common

Complications of spleen enlargement

Spleen enlargement is not corrected and treated with adequate medical help can cause complications, such as below:

  • Infections: If not treated timely, an enlarged spleencan drastically reduce the healthy red blood cells from the body, as well as reduce the platelets and white blood cells. This can make the body more prone to infections, as well as bleeding. It can also cause a condition known as anaemia.
  • Ruptured spleen: Generally, even when the spleen is of normal size, it is more prone to being ruptured in an accident, such as a car crash. However, the possibility of spleen rupture increases manifold when the spleen is enlarged. In case, the spleen is ruptured, it can lead to excessive bleeding into the abdominal cavity, which can be life-threatening.

Diagnosis of spleen enlargement

As mentioned in many patients, the enlarged spleen does not cause any symptoms. However, it can be diagnosed by a physical exam. Moreover, thin people can feel their spleen size increase than normal. In the physical exam, the healthcare provider gently examines the upper left abdomen portion to check for pain, tenderness or feel the size of the spleen.

Further, the doctor can use the following tests to confirm the analysis:

  • Blood tests including a complete blood count assessment to determine the number of red blood cells, white blood cells, and platelets.
  • Ultrasound or Computerized Tomography (CT) scan be used to diagnose if the spleen has enlarged in size and if it is pressing on other nearby organs.
  • Magnetic resonance imaging (MRI) can be used to check the blood flow from the spleen

In some cases, the doctor may subject the patient to further deep tests to understand the cause of the issue. These can include a bone marrow exam or a liver function test. In some severe cases, the doctor can also remove the spleen, when there is no identifiable cause. Once the spleen is removed, the doctor can use a microscope to check for lymphoma of the spleen.

Treatment of spleen enlargement

The type of treatment for the issue depends on the underlying cause of spleen enlargement. For example, if the enlargement is diagnosed to happen because of a bacterial infection, the doctor will prescribe antibiotics to treat the cause.

In case, the patient does not have any symptoms or no known cause, the doctor would suggest waiting until any complications occur. However, frequent check-ups would be required to assess the condition.

In other instances, where the enlarged spleen has caused a lot of complications, the healthcare provider may recommend a spleen removal surgery. However, the surgery can have possible risks depending on the general health of the patient. Hence, must be considered after careful evaluation with the doctor.

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