Splenomegaly is the enlargement of the spleen, which can be caused by infections, blood cancers, liver disease, and metabolic disorders. Symptoms are usually absent, but can include anemia, infections, and pain. Treatment involves addressing the underlying condition and surgery is a last resort.
Splenomegaly is a medical condition in which the spleen becomes enlarged. Causes of splenomegaly can include infections, blood cancers, liver disease and metabolic disorders, or even excessive pressure on the veins of the liver and spleen or blood clots in those veins. Specific diseases that can cause the condition include mononucleosis, syphilis, Hodgkin’s disease, Gaucher’s disease, and Niemann-Pick disease. Splenomegaly can affect people of all ages, and because symptoms of splenomegaly usually don’t present, the condition can go undetected until a doctor does a general physical exam.
The spleen is located in the left upper quadrant of the abdomen, just below the rib cage. Among its various functions, the spleen removes and destroys old or damaged blood cells, stores blood and platelets that help clotting, and prevents infections by creating white blood cells to fight off pathogens. Any or all of these functions may be impaired when the spleen enlarges through splenomegaly.
A normal spleen is usually the size of a human fist. When splenomegaly occurs, it can cause significant changes in organ function and can even lead to its partial destruction. For example, an enlarged spleen means that blood cells that function normally, as well as old and damaged ones, will be removed from the spleen. This means that the availability of healthy blood cells in a person’s bloodstream will be reduced.
If splenomegaly is suspected, a doctor may order blood tests or imaging such as an ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) scan to confirm a diagnosis. In cases where the causes are difficult to determine, specialized tests such as a bone marrow exam or liver function tests may be done. Some patients, however, may experience symptoms associated with splenomegaly. These can include anemia, recurring or frequent infections, easy bleeding, and pain radiating from the left upper abdomen to the shoulder. People who experience pain that is frequent, severe, or made worse by breathing should see a doctor right away, as this could indicate a ruptured spleen that can be potentially life-threatening.
Splenomegaly is treated by first addressing the underlying condition that encouraged the spleen to enlarge. For example, antibiotics may be prescribed to those fighting infections and chemotherapy or radiation may be given to patients suffering from Hodgkin’s disease. By treating the underlying condition, it is hoped that the spleen will return to its normal size. Surgery to remove an enlarged spleen is sometimes recommended, although it is usually a last resort.
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