Spleen Disease (Enlarged spleen) - Puyallup Surgical Consultants
standard-title Spleen Disease (Enlarged spleen)

Spleen Disease (Enlarged spleen)

Spleen Disease (Enlarged spleen)

About the Condition

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.

 

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Signs and Symptoms

An enlarged spleen may cause:

  • No symptoms in some cases
  • Pain or fullness 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

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Risk Factors

Anyone can develop an enlarged spleen at any age, but certain groups are at higher risk, including:

  • Children and young adults with infections, such as mononucleosis
  • People who have Gaucher’s disease, Niemann-Pick disease, and several other inherited metabolic disorders affecting the liver and spleen
  • People who live in or travel to areas where malaria is endemic

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Diagnostic Process

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:

  • Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system
  • Ultrasound or computerized tomography (CT) scan to help determine the size of your spleen and whether it’s crowding other organs
  • Magnetic resonance imagining (MRI) to trace blood flow through the spleen

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.

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Treatment Options

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.

 

 

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