Enlarged spleen or splenomegaly

Spleen is a small organ located just below the left rib cage. Normally the spleen is a size of the fist. There are various conditions where the spleen gets enlarged.

Symptoms:

An enlarged spleen often causes no symptoms.

• Pain in the left upper abdomen that may spread to the left shoulder
• Feeling full without eating or after eating only a small amount - this can occur when an enlarged spleen presses on your stomach
• Anemia
• Fatigue
• Frequent infections
• Easy bleeding.

Causes of enlarged spleen:

• 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 premature destruction of red blood cells
• Blood cancers, such as leukemia and Hodgkin's disease
• Metabolic disorders, such as Gaucher's disease and Niemann-Pick disease
• Pressure on the veins in the spleen or liver or a blood clot in these veins

Risk factors of enlarged spleen:

Children with infections such as mononucleosis are at especially high risk.

Complications of enlarged spleen:

Because an enlarged spleen can reduce the number of healthy red blood cells, platelets and white cells in bloodstream, you may develop anemia, increased bleeding or frequent infections. More serious is the risk of a ruptured spleen.

Diagnosis:

• Ultrasound scan of abdomen.
• CT scan of abdomen.

Treatment:

Treatment of an enlarged spleen is usually aimed at the underlying problem. Antibiotics may be used to treat infections.

If an enlarged spleen causes serious complications or the underlying problem can't be identified or treated, surgical removal of your spleen (splenectomy) may be an option.

Indications for splenectomy:

• When the spleen destroys red blood cells so rapidly that severe anemia develops
• When the spleen so depletes stores of white blood cells that infection is likely
• When the spleen so depletes stores of platelets that bleeding is likely
• When the spleen is so large that it causes pain or puts pressure on other organs
• When the spleen is so large that parts of it bleed or die.