Enlarged spleen (splenomegaly)
Enlarged spleen (splenomegaly)
Your spleen is an organ located just below your rib cage on your left side. A number of conditions — from infections to liver disease and some cancers — can cause an enlarged spleen, also known as splenomegaly (spleh-no-MEG-uh-lee).
Most people don't have symptoms with an enlarged spleen. The problem is often discovered during a routine physical exam. Your doctor can't feel a normal-sized spleen in adults — unless you're very slender — but can feel an enlarged spleen. If you have an enlarged spleen, your doctor will likely request imaging and blood tests to help identify the cause.
Treatment for an enlarged spleen focuses on relieving the underlying condition. Surgically removing an enlarged spleen isn't usually the first treatment, but it may be recommended in certain situations.
The spleen is a small organ normally about the size of your fist. But a number of conditions, including liver disease and some cancers, can cause your spleen to become enlarged. ...
An enlarged spleen may cause:
When to see a doctor
A number of infections and diseases can contribute to an enlarged spleen. The effects on your spleen may be only temporary, depending on how well your treatment works. Contributing factors include:
How the spleen works
An enlarged spleen affects each of these vital functions. For instance, as your spleen grows larger, it begins to filter normal red blood cells as well as abnormal ones, reducing the number of healthy cells in your bloodstream. It also traps too many platelets. Eventually, excess red blood cells and platelets can clog your spleen, interfering with its normal functioning. An enlarged spleen may even outgrow its own blood supply, which can damage or destroy sections of the organ.
Anyone can develop an enlarged spleen at any age, but certain groups are at higher risk, including:
Potential complications of an enlarged spleen are:
Tests and diagnosis
An enlarged spleen is usually detected during a physical exam. Your doctor can often feel the enlargement by gently examining your left upper abdomen, just under your rib cage. However, in some people — especially those who are slender — a healthy, normal-sized spleen can sometimes be felt during an exam.
Your doctor may confirm the diagnosis of an enlarged spleen with one or more of these tests:
Imaging tests aren't always needed to diagnose an enlarged spleen. But if your doctor recommends imaging, you generally don't need any special preparation for an ultrasound or MRI. If you're having a CT scan, however, you may need to refrain from eating before the test. If you need to prepare, your doctor will let you know well in advance.
Finding the cause
In some cases, a sample of solid bone marrow is removed in a procedure called a bone marrow biopsy. Or you may have a bone marrow aspiration, which removes the liquid portion of your marrow. In many cases, both procedures are performed at the same time (bone marrow exam).
Both the liquid and solid bone marrow samples are frequently taken from the same place on the back of one of your hipbones. A needle is inserted into the bone through an incision. Because bone marrow tests cause discomfort, you'll receive either general or local anesthesia before the test.
Because of the risk of bleeding, a needle biopsy of the spleen is almost never done.
Occasionally, when there's no explanation for an enlarged spleen despite a thorough investigation for a cause, your doctor may recommend surgery to remove your spleen. After surgical removal, the spleen is examined under a microscope to check for possible lymphoma of the spleen.
Treatments and drugs
If the cause of an enlarged spleen can be identified, treatment focuses on the underlying problem. For example, if you have a bacterial infection, treatment will include antibiotics.
If you have an enlarged spleen but don't have any symptoms and the cause can't be found, your doctor may suggest watchful waiting. You'll have to see your doctor for revaluation in six to 12 months, or sooner if you develop any symptoms.
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. In fact, in chronic or critical cases, surgery may offer the best hope for recovery.
But elective spleen removal requires careful consideration. You can live an active life without a spleen, but you're more likely to contract serious or even life-threatening infections after having your spleen removed. Sometimes radiation can shrink your spleen so that you can avoid surgery.
Reducing infection risk after surgery
Lifestyle and home remedies
If you have an enlarged spleen, avoid contact sports — such as soccer, football and hockey — and limit other activities as recommended by your doctor. Modifying your activities can reduce the risk of a ruptured spleen.
It's also important to wear a seat belt. If you're in an accident, a seat belt can help prevent injury to your spleen.
Finally, be sure to keep your vaccinations up to date because your risk of infection is increased. That means at least an annual flu shot, and a tetanus, diphtheria and pertussis booster every 10 years. Ask your doctor if you need any additional vaccines.
Last Updated: 2013-07-26
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