The spleen carries out many functions in the body. The organ—which lies below the left ribs— is part of the lymphatic system. It not only filters the blood but also helps fight invading pathogens. Interestingly, though, it is possible to live without a spleen, though this leaves individuals more susceptible to infection. Many conditions can affect the spleen; it is not uncommon for various diseases to cause an enlarged spleen.
The spleen—a soft, squishy organ—plays various critical roles. In addition to recycling old red blood cells, it serves as storage for platelets and white blood cells, the former of which is essential for blood clotting. As part of the immune system, it also produces white blood cells and antibodies, both of which help to prevent infection.
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In a healthy individual, the spleen is usually the size of a fist. Due to various causes, however, the organ can become enlarged; when this happens, there can be many consequences. For instance, the spleen may fail to filter the blood properly. Sometimes, it may grow so large that it outgrows its blood supply. Rather than being a disease itself, an enlarged spleen is often a sign of an underlying health problem. If left untreated, the situation can lead to complications, some of which may be life-threatening.
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An enlarged spleen is generally more common among those with severe infections such as mononucleosis. Individuals with liver disease also have a greater risk of developing the condition. Some other risk factors include Gaucher’s disease and Niemann-Pick disease, two metabolic disorders. People who live in areas where malaria is rampant are also more susceptible.
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In many cases, an enlarged spleen does not cause any noticeable symptoms. Because of this, it often goes undetected until a routine physical exam. In some individuals, however, an enlarged spleen can lead to symptoms such as pain in the left upper abdomen, hiccups, a feeling of fullness after eating a small meal, fatigue, and anemia. Frequent infections may also develop.
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A number of viral, bacterial and parasitic infections can cause the spleen to enlarge; some of the most common are mononucleosis, endocarditis, syphilis, and malaria. Liver disease such as cirrhosis can also cause an enlarged spleen, as it increases pressure in the vein that supplies the organ's blood. Other causes include cancers such as lymphoma, leukemia, and Hodgkin’s lymphoma. Hemolytic anemia—a condition in which the body destroys red blood cells faster than it makes them—may also be responsible in some cases.
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While an enlarged spleen is not always evident, certain symptoms and signs should warrant an appointment with the doctor. For instance, an individual should seek medical help if they are experiencing pain in the left upper abdomen—especially if it worsens during breathing. Prompt diagnosis plays an important role in treating the underlying health problem.
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The spleen is typically not palpable in healthy individuals. When it enlarges, however, a physician can detect it during a physical exam. To confirm the diagnosis, she may choose to perform an MRI or a CT scan, the latter of which will help determine whether or not the organ is pressing on any other organs. Blood tests may also provide clues as to what is causing the enlargement. Physicians rarely conduct spleen biopsies as the procedure often leads to uncontrollable bleeding.
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Treatment depends on the underlying disorder. For instance, antibiotics can treat enlargements caused by bacterial infections. In chronic or severe cases, however, surgical removal of the spleen—also known as a splenectomy—may be necessary. While it is possible to live without a spleen, this greatly increases one’s risk of infection.
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There are a few ways to help prevent infection after a splenectomy. To start, the physician will likely prescribe antibiotics. From there, it is important to keep up to date with vaccinations, as they are one of the most effective ways of preventing disease, particularly in those with lowered immunity. Individuals should also avoid traveling to areas where diseases such as malaria are rampant.
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Over time, splenomegaly can reduce the number of healthy blood cells in the body; this results in frequent infections. Not only that, but an enlarged spleen is much more likely to rupture. Potentially life-threatening, a rupture occurs when the covering of the organ breaks open. Depending on the size of the rupture, this may lead to heavy internal bleeding in the abdominal cavity.
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