Why is it important?
Your spleen is a small organ that is important to your body’s ability to function, but do you know what it does? If it is injured, it can cause serious problems. Where is it located in your body? How do you know if it has been injured and what do you do if it has?
Definition
Your spleen is located in the upper left part of your abdomen next to your stomach and is protected by your rib cage unless it is enlarged. It varies in shape and size, but usually is fist-shaped and four inches long. The spleen plays multiple roles in your body function, but one of the main jobs is to filter the blood. This process helps your immune (lymphatic) system by removing old red bloods cells (they carry the oxygen from your lungs to the cells in your body and carry carbon dioxide from your body to your lungs to be expelled) and produces/stores platelets (they help your body form clots) and white blood cells (they help your body fight infections). It is also specialized at fighting certain kinds of bacteria that cause pneumonia and meningitis.
There are several illnesses that can affect your spleen. An enlarged spleen (splenomegaly) is when your spleen increases in size. This isn’t always a sign of a problem, but can mean that your spleen has been doing its job but has become overactive. Hypersplenism is the term for an overactive spleen that is removing and destroying large amounts of blood cells. The other reasons that your spleen can become enlarged are from viral infections (mononucleosis), parasitic infections (toxoplasmosis), bacterial infections (endocarditis), leukemia (a type of cancer that causes an increase of white blood cells to the point that there are more of them than red blood cells), lymphoma (Hodgkin’s disease), inflammatory diseases (sarcoidosis, lupus, rheumatoid arthritis), cancer that has metastasized, cyst (non-cancer, fluid-filled sac), large abscess (pus-filled sac), infiltrative diseases (Gaucher’s disease, amyloidosis), cirrhosis, other liver diseases and trauma to the spleen. The concerned with an enlarged spleen is that it is more susceptible to being injured, which can cause significant internal bleeding due to the amount of blood that filters through it.
The other major concern with your spleen is the possibility of rupture. This typically occurs because of some kind of trauma to the area where the spleen is located. However, it can also occur if you have glandular fever (Viral Mononucleosis), blood diseases (hemolytic anemia or lymphoma), or malaria. A ruptured spleen doesn’t always happen initially, but can take place days or weeks after. Whenever it happens, it is considered a life-threatening emergency. A couple of other diseases that affect the spleen are sickle cell (can lead to damage to the spleen itself and people who experience this will often need immunizations to prevent illness that the spleen protects against) and thrombocytopenia (a low blood platelet count because the spleen is enlarged and storing excessive amounts). Asplenia is the term for absence of normal spleen function and this puts anyone who has this at increased risk for infection. Hyposplenism is when the spleen has reduced functioning but not as severe as asplenia.
Treatment
Depending on what is wrong with your spleen, it will determine what treatment you need. For an enlarged spleen, symptoms are rare but if you find that you can’t eat a large meal, feel discomfort/fullness/pain on the upper left side of your abdomen with it spreading to your left shoulder, then that can be a sign that your spleen is enlarged. If you have pain and it gets worse when taking a deep breath, then you need to be evaluated by a doctor immediately. Typically, it is found on a physical exam because your doctor will be able to feel your spleen beneath your ribs on the left side (this is not normal). Treatment usually involves a wait and see approach. The most important thing to do is to limit activities that could rupture your spleen, such as not participating in contact sports until cleared by your doctor. Complications could lead to having to have your spleen removed (splenectomy). This could save your life but means that you would need vaccines and to take medications to prevent infections that your body will no longer be capable of clearing from your body (this is a life-long change). With a ruptured spleen, you will have pain in your upper left abdomen that radiates to your left shoulder. You might also have blurred vision, lightheadedness, confusion, fainting, anxiety/restlessness, nausea, paleness and shock (a sudden drop in blood pressure and heart rate—sign condition is severe). Also, your abdomen may feel hard and swollen due to the internal bleeding. The only treatment for this is emergency surgery to remove your spleen and to control the bleeding.
Prevention
The best prevention of issues with your spleen is to avoid and/or treat any diseases that can affect your spleen. Since the number of issues that do this are vast, the list of what not to do could be endless. The best bet is to not let infections go untreated and if you have any injuries to the area around your spleen that make you question whether or not it could be injured, then you need to be examined by a doctor.
Your spleen plays a vital role in your body’s ability to survive and fight infections. It is important to take care of it. If you have any questions about your spleen, please speak with your doctor. If you would like more information about an enlarged spleen or ruptured spleen, please visit the Mayo Clinic pages at https://www.mayoclinic.org/diseases-conditions/enlarged-spleen/symptoms-causes/syc-20354326 or https://www.mayoclinic.org/diseases-conditions/ruptured-spleen/symptoms-causes/syc-20352317