Enlarged Spleen: Causes, Symptoms, and Treatments

The spleen is a small organ located right behind your left rib cage. An enlarged spleen can be caused by a variety of factors, including infections, liver illness, and various cancers. The medical term for an enlarged spleen is splenomegaly (spleh-no-MEG-uh-lee).

Usually, an enlarged spleen does not produce any symptoms. Most of the time, it’s identified during a standard physical examination. Unless the spleen is huge, a doctor can’t generally feel it in an adult. An enlarged spleen can be diagnosed via imaging and blood tests.

The cause of an enlarged spleen determines the treatment. Surgery to remove an enlarged spleen is rarely necessary, but it is occasionally advised.

What Does Pain from the Spleen Feel Like?

A sense of pain or discomfort in the upper left side of the abdomen, where the spleen is located, is a common sign of an enlarged spleen. You may also feel full after only a tiny amount of food has been consumed. This occurs when the spleen enlarges to the point where it presses against the stomach.

What Are the Symptoms of Enlarged Spleen?

An enlarged spleen typically causes no signs or symptoms, but sometimes it causes:

Pain or fullness in the left upper belly that can spread to the left shoulder
A feeling of fullness without eating or after eating a small amount because the spleen is pressing on your stomach
Low red blood cells (anemia)
Frequent infections
Bleeding easily
When to see a doctor: See your doctor promptly if you have pain in your left upper belly, especially if it’s severe or the pain gets worse when you take a deep breath.

What Are the Causes of Enlarged Spleen?

An enlarged spleen can be caused by a variety of infections and diseases. Depending on the treatment, the enlargement could be temporary. The following are some of the contributing factors:

Viral infections, such as mononucleosis
Bacterial infections, such as syphilis or an infection of your heart’s inner lining (endocarditis)
Parasitic infections, such as malaria
Cirrhosis and other diseases affecting the liver
Various types of hemolytic anemia — a condition characterized by early destruction of red blood cells
Blood cancers, such as leukemia and myeloproliferative neoplasms, and lymphomas, such as Hodgkin’s disease
Metabolic disorders, such as Gaucher disease and Niemann-Pick disease
Pressure on the veins in the spleen or liver or a blood clot in these veins
Autoimmune conditions, such as lupus or sarcoidosis

What Are the Risk factors

Anyone can develop an enlarged spleen at any age, but certain groups are at higher risk, including:

Children and young adults with infections, such as mononucleosis
People who have Gaucher disease, Niemann-Pick disease, and several other inherited metabolic disorders affecting the liver and spleen
People who live in or travel to areas where malaria is common

What Are the Complications?

Potential complications of an enlarged spleen are:

Infection: The quantity of healthy red blood cells, platelets, and white cells in your bloodstream can be reduced by an enlarged spleen, leading to more diseases. Anemia and excessive bleeding are also possible side effects.
Ruptured spleen: Even healthy spleens are soft and easily damaged, especially in car crashes. The possibility of rupture is much greater when your spleen is enlarged. A ruptured spleen can cause life-threatening bleeding in your belly.

Enlarged Spleen Diagnosis

A physical exam is frequently used to detect an enlarged spleen. By carefully probing your left upper belly, your doctor can often detect it. A healthy, normal-sized spleen can sometimes be felt during an exam in some people, especially those who are skinny.

Your doctor might order these tests to confirm the diagnosis of an enlarged spleen:

Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system and liver function
Ultrasound or CT scan to help determine the size of your spleen and whether it’s crowding other organs
MRI to trace blood flow through the spleen

How Do You Treat an Enlarged Spleen?

The cause of an enlarged spleen is addressed in treatment. If you have a bacterial infection, for example, antibiotics will be prescribed.

Watchful Waiting

If you have an enlarged spleen but no symptoms and the cause cannot be determined, your doctor may advise you to wait. If you have symptoms, you should see your doctor in 6 to 12 months for a reevaluation.

Spleen Removal Surgery

Surgery to remove your spleen (splenectomy) may be an option if an enlarged spleen creates substantial consequences and the cause cannot be discovered or managed. Surgery may be the best hope for recovery in chronic or serious conditions.

Choosing to have your spleen removed is a big decision. You may live an active life without a spleen, but removing it increases your risk of serious or even life-threatening infections.

Reducing Infection Risk After Surgery

After spleen removal, certain steps can help reduce your risk of infection, including:

A series of vaccinations before and after the splenectomy. These include the pneumococcal (Pneumovax 23), meningococcal and haemophilus influenzae type b (Hib) vaccines, which protect against pneumonia, meningitis and infections of the blood, bones and joints. You’ll also need the pneumococcal vaccine every five years after surgery.
Taking penicillin or other antibiotics after your surgery and anytime you or your doctor suspects the possibility of an infection.
Calling your doctor at the first sign of a fever, which could indicate an infection.
Avoid travel to parts of the world where certain diseases, such as malaria, are common.