Liver disease is one of the most common causes of an enlarged spleen. Conditions that affect the liver can result in portal hypertension, which is elevated blood pressure in the venous system that drains blood into the liver from the intestine, stomach, pancreas, and spleen.
Portal hypertension can cause pressure to build up and blood to pool, which can enlarge the spleen. An enlarged spleen may not have any symptoms but can cause decreased appetite or upper left-side abdominal pain that radiates to the back.

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