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Spleen

Enlarged Spleen (Splenomegaly)

The spleen is simply a blood filter (like an oil filter) that filters out old red blood cells and certain types of bacteria. The spleen also has immune properties by making and storing white blood cells. It is roughly the size of a fist and it sits in the left lower rib cage near the back.

The spleen may enlarge as a result of a number of conditions including infections and diseases of blood cells.

Symptoms

Very often someone with an enlarged spleen do not experience much symptoms. Occaionally you may feel a dragging sensation on the left side, unable to eat a full meal, tired, anaemia, prone to infections and tendency to bleed and bruises easily. Enlarged spleens are also more prone to rupture which is life-threatening and is a surgical emergency.


​Causes of Enlarged Spleen Splenomegaly:​​​​​​​​​​​
  • Viral or parasitic infections like glandular fever and malaria.

  • Liver cirrhosis including clots in the vein that drains the spleen causing back pressure on the spleen.

  • Haemolytic anaemia like idiopathic thrombocytopenia (ITP), spherocytosis

  • Cancers of blood cells like leukaemia and Hodgkin's lymphoma

  • Rare conditions like Gaucher's disease and Niemann-Pick disease.

Diagnosis of an Enlarged Spleen:

Blood tests are the test of choice to find the cause of the splenomegaly. Other tests may include bone marrow biopsy. An ultrasound but more often a CT scan is used to determine the size of the spleen.

 

​Treatment of an Enlarged Spleen:

Treatment of splenomegaly depends on the cause. These may include antibiotics, chemotherapy or radiotherapy. Surgery to remove the spleen (splenectomy) may be required if the enlarged spleen causes serious complications. Splenectomy may offer the best chance for recovery in chronic or severe cases.

Splenectomy surgery for an Enlarged Spleen

Most enlarged spleens even ones the size of rugby balls can be removed by laparoscopic (keyhole) surgery. The recovery from this is significantly quicker than by open surgery. Most patient may go home after 1-2 nights hospital stay and depending on the underlying condition, full recovery is usually expected after 7-10 days.
 

Following splenectomy you will need to be on life-long antibiotics as you are more prone to contracting infections and you will also require pneumococcal (Pneumovax), haemophilus influenzae type b (Hib), and meningococcal vaccines. Other than these precautions you can expect to live an active life without a spleen.