Enlarged Spleen – Symptoms and Causes
Overview
The spleen sits under the left rib cage and plays important roles in your body. When it becomes enlarged, doctors call this condition splenomegaly.
Many health issues can cause an enlarged spleen, including:
- Infections
- Liver disease
- Certain types of cancer
Most people with an enlarged spleen don’t notice any symptoms. Often, the condition is discovered during a regular check-up when a doctor examines your abdomen.
In healthy adults, doctors usually can’t feel the spleen during a physical exam unless it’s larger than normal.
To confirm an enlarged spleen and find its cause, doctors may order:
- Blood tests
- Imaging tests (like ultrasound or CT scan)
Treatment depends entirely on what’s causing the enlargement. While surgery to remove the spleen isn’t usually the first option, it might be recommended in certain situations.
Signs and Symptoms
People with an enlarged spleen often have no symptoms. However, some may experience:
- Pain or fullness in the upper left part of the belly that might extend to the left shoulder
- Feeling full quickly when eating because the enlarged spleen presses on the stomach
- Anemia (low red blood cell count)
- More frequent infections than usual
- Easy bleeding
When to Get Medical Help
If you feel pain in your upper left abdomen, don’t wait to seek medical care. This is especially important if the pain is intense or gets worse when you breathe deeply.
Prompt medical attention can help identify the cause and prevent possible complications.
Causes of Enlarged Spleen
Many infections and diseases can lead to an enlarged spleen. Sometimes this enlargement is temporary and improves with treatment.
Several factors may cause the spleen to become larger than normal.
Common causes include:
- Viral infections like mononucleosis
- Bacterial infections such as syphilis or endocarditis (infection of the heart’s inner lining)
- Parasitic infections including malaria
- Liver problems such as cirrhosis
- Blood disorders like hemolytic anemia (when red blood cells break down too quickly)
- Cancer including leukemia, lymphoma, and other blood cancers
- Metabolic disorders such as Gaucher disease and Niemann-Pick disease
- Blood flow problems including pressure or clots in the veins of the spleen or liver
- Autoimmune conditions like lupus or sarcoidosis
How Your Spleen Functions
Your spleen sits under your rib cage next to your stomach on the left side of your abdomen. Its size usually depends on your height, weight, and sex.
This soft, spongy organ performs three main jobs:
- Blood Cleaning: It filters out and destroys old and damaged blood cells.
- Infection Control: It makes white blood cells called lymphocytes and acts as a first defense against harmful organisms.
- Blood Cell Storage: It holds red blood cells and platelets that help your blood clot.
When your spleen becomes enlarged, it may not work properly. This affects all three of these important functions.
Risk Factors
Several groups have a higher chance of developing an enlarged spleen:
- Children and young adults fighting infectious diseases like mononucleosis
- Individuals with inherited metabolic disorders that affect liver and spleen function, such as Gaucher disease and Niemann-Pick disease
- People who travel to or live in regions where malaria is common
Complications
When the spleen becomes enlarged, several serious health issues may develop. These complications can affect different systems in the body and sometimes require immediate medical attention.
Infection Risk
People with an enlarged spleen often have fewer healthy blood cells circulating in their body. This reduction includes:
- White blood cells (which fight infection)
- Red blood cells (which carry oxygen)
- Platelets (which help blood clot)
With fewer white blood cells available to fight off germs, infections become more common and may be harder to overcome.
Blood-Related Problems
An enlarged spleen can lead to:
- Anemia (low red blood cell count) causing fatigue and weakness
- Increased bleeding and bruising due to low platelet counts
Rupture Danger
Perhaps the most serious complication is a ruptured spleen. The spleen is naturally soft and can tear easily, especially during accidents or injuries. When enlarged, this risk becomes significantly higher.
A ruptured spleen is a medical emergency that causes:
- Severe bleeding in the abdomen
- Sharp pain in the left upper abdomen
- Rapid heart rate
- Dizziness or fainting
- Life-threatening blood loss if not treated quickly
Because of these serious complications, doctors carefully monitor patients with enlarged spleens. They may recommend avoiding contact sports and other activities that could increase the risk of injury to the spleen area.
