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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• What is an enlarged spleen?
• What are the causes of an enlarged spleen?
• What are the symptoms of an enlarged spleen?
• When should I seek medical care for an enlarged spleen?
• How is enlarged spleen diagnosed?
• What is the treatment for an enlarged spleen?
• What are the complications of an enlarged spleen?
• Can an enlarged spleen be prevented?
• What is the outlook (prognosis) for an enlarged spleen?
• Enlarged Spleen At A Glance
• Patient Comments: Enlarged Spleen (Splenomegaly) - Cause
• Patient Comments: Enlarged Spleen (Splenomegaly) - Symptoms
• Patient Comments: Enlarged Spleen (Splenomegaly) - Treatment
• Enlarged Spleen (Splenomegaly) Index

When the spleen enlarges, it loses some of the protective covering of the lower rib cage and becomes more vulnerable to injury. The enlarged spleen is fragile and can be damaged with relatively minor blows to the upper abdomen. It is a relatively solid organ and can fracture or crack causing significant and potentially life-threatening bleeding.

The enlarged spleen can also trap an excessive number of blood cells within it causing:

• anemia (decreased numbers of red blood cells), which may lead to weakness, shortness of breath, and easy fatigue;
  
  
• leukopenia (decreased white blood cells), which may lead to increased risk of infection; and
  
  
• thrombocytopenia (decreased platelets), which may lead to infection or to bleeding problems.

If the spleen needs to be removed, there is an increased risk of infection, especially due to bacteria such as pneumococcus (Streptococcus pneumoniae), Hemophilus influenza, and meningococcus (Neisseria meningitides). It is important to consider keeping immunizations (particularly the pneumococcal vaccine, since about 50% to 90% of post splenectomy infections are due to encapsulated streptococci) current against these infections in patients whose spleen has been removed.

Splenomegaly is a complication of an underlying disease or illness and in itself cannot be prevented. Ideally, early recognition of an enlarged spleen may help the health care practitioner come to an early diagnosis as to the cause and perhaps prevent further spleen enlargement.