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.
Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.
Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Symptoms you may experience with an enlarged spleen include:
The spleen is an important organ in the body that has a variety of responsibilities. The spleen:
The spleen is located in the left upper quadrant of the abdomen, just beneath the diaphragm and next to the stomach. It has a very rich blood supply since it is responsible for filtering blood, and it is protected by the 9th, 10th, and 11th ribs. Normally, it is the size of an orange or a small fist.
The spleen has two types of tissue; the red pulp is responsible for filtering blood, while the white pulp is responsible for its immune function.
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.
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 found in sickle cell disease, thalassemia, and spherocytosis, may be damaged when they try to squeeze through small capillary blood vessels. These damaged red blood cells need to be culled from the bloodstream and are filtered out by the spleen.
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 affect pressure in the splenic vein. The decreased ability of blood to drain from the spleen causes it to become congested and grow 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.
Other cancers can spread or metastasize to the spleen and cause it to enlarge.
Certain metabolic diseases may cause the spleen to enlarge, including Hurler Syndrome, Gaucher disease and Niemann-Pick Disease.
In sarcoidosis and amyloidosis the spleen can be involved and become enlarged with the abnormal protein deposits.
Some infections may cause splenomegaly including:
Trauma, for example, from a car accident, can damage the spleen.
An enlarged spleen is most often found on physical examination. Either the health care practitioner is looking for an enlarged spleen because of a diagnosis that has already been made, or it is found incidentally when initially examining a patient (and it then serves as a clue to an underlying diagnosis).
With its location protected beneath the left lower ribs, a normal spleen is usually not felt on physical exam, except in some unusually thin individuals. As it enlarges, the spleen grows from the left upper quadrant of the abdomen towards the umbilicus (the belly button). Sometimes the doctor will ask the patient to roll on their right side to better attempt to feel the spleen. An enlarged spleen may not be felt in obese patients.
On occasion, an enlarged spleen may be diagnosed by plain X-ray, ultrasound, abdominal CT scan, or MRI (magnetic resonance imaging).
Because splenomegaly is due to an underlying illness, treatment will depend upon the primary cause. In some situations, removal of the spleen (splenectomy) may be part of the treatment. For example, in hereditary spherocytosis, a condition in which red blood cells are abnormal and shaped like a sphere instead of the concave disk shape. These abnormal red blood cells are filtered from the blood stream, which causes anemia and an enlarged spleen. Splenectomy limits the number of red blood cells destroyed and helps treat the disease.
There are no natural treatments for an enlarged spleen.
Perhaps the most important worry with an enlarged spleen is the risk of injury as it grows beyond the protection of the rib cage. A minor injury may cause it to rupture and bleed. Spleen injuries are often treated by observation, but on occasion, the spleen can rupture causing life threatening internal bleeding requiring surgery for to remove the spleen. This is the reason that teenagers and young adults diagnosed with infectious mononucleosis need to wait until the spleen returns to its normal size, and is protected by the rib cage, before participating in activities where the enlarged spleen could be damaged.
All types of blood cells may become trapped in a large spleen. Anemia (low red blood cell count) may cause
Low platelet count (thrombocytopenia) may be associated with an increased risk of bleeding.
Leukopenia (low white blood cell count) may be associated with an increased risk of infection.
Should the spleen need to be removed surgically (splenectomy), the risk of certain infections increases, and the patient will need to make certain that their immunizations are up to date, especially against pneumococcus, meningococcus and haemophilus influenzae.
Often, the prognosis for an enlarged spleen depends entirely upon the underlying illness. For example, in patients with infectious mononucleosis, the spleen will return to its normal size once the infection resolves.
In some instances, the spleen may need to be removed and the risk of infection may increase. In other cases, the spleen will remain enlarged and leave the patient at an increased risk for bleeding, spleen rupture, and infection.
An enlarged spleen is the consequence of an underlying illnesses, many of which may not be anticipated or prevented.
Finally, certain infectious diseases such as HIV, malaria, tuberculosis, and anaplasmosis can be prevented if the appropriate measures are taken to minimize the risks of acquiring the disease.
Symptoms include yellowing of the skin (jaundice), itching, and fatigue.
The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
A complete blood count (CBC) is a calculation of the cellular makeup of blood. A CBC measures the concentration of white blood cells, red blood cells, platelets in the blood, and aids in diagnosing conditions and disease such as malignancy, anemia, or blood clotting problems.
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure.
Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure.
Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
CT scan (computerized tomography) is a procedure that uses X-rays to scan and take images of cross-sections of parts of the body. CT scan can help diagnose broken bones, tumors or lesions in areas of the body, blood clots in the brain, legs, and lung, and lung infections or diseases like pneumonia or emphysema.
MRI (magnetic resonance imaging) is a procedure that uses strong magnetic fields and radiofrequency energy to make images of parts of the body, particularly, the organs and soft tissues like tendons and cartilage.
Both CT and MRI are painless, however, MRI can be more bothersome to some individuals who are claustrophobic, or suffer from anxiety or panic disorders due to the enclosed space and noise the machine makes.
MRI costs more than CT, while CT is a quicker and more comfortable test for the patient.
Deep vein thrombosis (DVT) is a blood clot in the deep veins, and can be caused by broken bones, trauma to a limb, immobility, medications, smoking, cancer, genetic predisposition, and cancer. Symptoms of a deep vein thrombosis in a leg are swelling, tenderness, redness, warmth, and pain.
Treatment for DVT include medications and surgery.
Hiccups are a sudden, involuntary contraction of the diaphragm muscle. In general hiccups are just a temporary condition. Some of the causes of hiccups include certain medications, surgery, eating or drinking too much, spicy foods, diseases or conditions that irritate the nerves controlling the diaphragm, strokes, brain tumors, liver failure, and noxious fumes. There are a variety of home remedies and treatments that can be used to get rid of hiccups.
More Health News »
Patient Comments
What caused your case of an enlarged spleen?
Post View 21 CommentsWhat symptoms did you experience with an enlarged spleen?
Post View 6 CommentsWhat treatments were effective for your case of enlarged spleen?
Post View 5 CommentsPlease share your experience with an enlarged spleen.
Post View 3 Comments