Enlarged Spleen (cont.)

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What are the causes of an enlarged spleen?

The spleen will enlarge when it performs more of its duties to filter blood or to manufacture blood cells. Therefore, any disease or condition that damages red blood cells, and requires them to be filtered and removed from the blood stream, will cause the spleen to become larger.

Blood disorders

Conditions such as hemolytic anemia, where red blood cells are damaged and broken down (hemolyzed) can cause the spleen to enlarge. Misshapen red blood cells, like those produced in sickle cell anemia, thalassemia, and spherocytosis; may not be able to maneuver through small capillary blood vessels and then become damaged. The damaged cells need to be culled and filtered by the spleen.

Decreased blood flow

The spleen will enlarge if there is a decrease in blood flow through the splenic vein. This may cause spleen congestion and enlargement. This situation may be associated with liver disease and portal hypertension. Damage to liver cells makes it difficult for blood to flow normally, and as blood backs up in the portal vein system, it may also affect pressure in the splenic vein. This increased pressure decreases blood draining from the spleen and causes it to become congested and larger. People with congestive heart failure may have an enlarged liver and spleen because of poor blood flow to and from the heart.


Leukemia and lymphoma may be associated with abnormal white cells that can invade the spleen and increase its size.

Metabolic diseases

Certain metabolic diseases may cause the spleen to enlarge, including Hurler Syndrome, Gaucher Disease and Niemann-Pick Disease.


Some viral infections may cause splenomegaly including:

What type of pain, and where is the pain located with an enlarged spleen?

An enlarged spleen, by itself, usually does not cause any symptoms. Because of its location, should it enlarge, the spleen can irritate the diaphragm and cause hiccups and perhaps some pain in the left upper quadrant of the abdomen. It may also compress the stomach, causing the person to feel full after eating a small amount, and therefore unable to eat large meals.

Medically Reviewed by a Doctor on 4/3/2014

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