Introduction
The spleen is a small and soft organ situated in the left upper quadrant of the abdominal cavity to the left of the stomach and under the diaphragm. It is part of the lymphatic and immune system, helping the body fight off infections and clearing up the blood of waste products. Most of patients can live without the spleen if they need to have a surgical operation to take it out. Rarely, these patients may suffer from severe bacterial infection.
Causes of Enlarged Spleen (Splenomegaly)
Infections
- Viral infections, such as mononucleosis.
- Parasitic infections, such as toxoplasmosis.
- Bacterial infections, such as endocarditis (an infection of your heart's valves).
Cancer
- Leukemia, a cancer in which white blood cells displace normal blood cells.
- Lymphoma, a cancer of lymph tissue, such as Hodgkin's disease.
Other causes of an enlarged spleen include:
- Inflammatory diseases such as sarcoidosis, lupus, and rheumatoid arthritis.
- Cancer that has spread (metastasized) to the spleen.
- A cyst in the spleen.
- A large abscess, a pus-filled cavity usually caused by a bacterial infection.
- Infiltrative diseases such as Gaucher's disease, amyloidosis, or glycogen storage diseases.
Infection
As one of the functions of the spleen is to help in immune system, large spleen can be as a result of infection. Infections can either be viral (e.g.: Infectious mononucleosis which can cause enlarged and fragile spleen) or hepatitis, malaria, and brucellosis.
Blood Disorders
The spleen is also useful to clean out cellular waste and debris. Therefore, diseases lead to increased cellular waste can lead to a large spleen. One such condition is sickle cell disease, in which the red blood cells are fragile and break easily. The spleen stores these cells, becoming enlarged. Eventually the spleen can also trap normal red blood cells, leading to worsening anaemia. Other blood conditions include hereditary spherocytosis and hereditary elliptocytosis, both conditions in which the red blood cells are abnormally shaped and fragile.
Splenic Rupture
As the spleen is supplied with numerous blood vessels, its injury is a real surgical emergency. As a result of blood leaking freely into the abdominal cavity, there will be a cardiovascular compromise which may lead to a shock. Rupture of the spleen might be a life-threatening condition.
Diagnosis
- Ultrasound of the abdomen.
- CT scan of the abdomen.
- Specific blood tests for infections.
- Haematology consult and workup if haematological disorders are suspected.
