The spleen is an abdominal organ that is not vital for survival, but plays many important roles in the human physiology. People are often unaware of the existence, location, and functions of the spleen. Only when the spleen gets affected by a disease or an injury does one realize about its existence and importance. The spleen is a fist-sized organ that is located in the left upper quadrant of the abdominal cavity.
The location of the organ is covered by the left side of the ribcage. Due to the shielding by the ribs, one cannot feel the spleen by pressing the abdomen. The spleen functions as a filter for the blood. A large population of the immune cells also live in the spleen. These immune cells help in removing the debris and microbes from the blood that passes through the spleen.
Worn out red blood cells are also removed from the circulating blood and destroyed by the spleen. New red blood cells produced by the bone marrow replace the old red blood cells that are removed by the spleen. Spleen is also capable of producing new red blood cells. However, this hematopoietic function of the spleen doesn’t come to the fore unless there is severe anemia.
Types of Spleen Problems
Most of the problems with the spleen can be largely subdivided into two categories:
Injured or ruptured spleen
Trauma that occurs on the left side of the abdomen can result in a spleen injury or a rupture of the spleen. Possible scenarios that may lead to a ruptured spleen include vehicle accidents, blunt force trauma, sharp force trauma, and violent contact sports.
Swelling and enlargement of the spleen
A swelling or enlargement of spleen is medically referred to as splenomegaly. Enlargement of the spleen is often noticed alongside an enlargement of the liver. Such cases are referred to as hepatosplenomegaly. Causes of swelling and enlargement of spleen include infections, abscesses, cysts, liver diseases, autoimmune diseases, and cancers. It is important to note that splenomegaly is a sign of an underlying condition (either limited to the spleen or systemic) rather than a disease.
Other Less Common Spleen Problems
The following are some other types of spleen problems that may occur relatively less frequently:
- Splenic infarct: Splenic infarct is caused by a blockage of the splenic artery that supplies the spleen. Due to the lack of blood supply, a part of the splenic tissue may die.
- Splenic vein thrombosis: The blood flow out of the spleen may get blocked due to the presence of a blood clot within the splenic vein.
- Hypersplenism: Hypersplenism refers to an overactive spleen.
- Cancer of the spleen: Cancers can sometimes arise from the spleen tissue. However, it is also possible for cancers located elsewhere in the body to metastasize to the spleen.
How to Spot Spleen Problems
The signs and symptoms of spleen problems are generally very vague. Therefore, most people are surprised to hear of spleen problems. The following are some of the signs and symptoms that may be associated with any problems in the spleen.
Pain and tenderness in the abdomen
The pain caused by spleen problems is typically felt in the upper left abdominal region. However, pain in this region is often attributed to the stomach and the kidney that also lie next to the spleen. Application of pressure over the left abdominal region may reveal a tenderness in the area.
However, there is no distinct characteristic of the pain that emanates from the spleen. Pain usually does not occur in cases where there is a mild to moderate swelling of the spleen. A diffuse abdominal pain, accompanied by low blood pressure (medically referred to as hypotension) can be a sign of serious bleeding within the abdominal cavity.
Read more on spleen pain location.
Feeling of fullness in the abdomen
A mild to moderate enlargement of the spleen usually does not cause any pain. However, enlargement of the spleen may cause a feeling of fullness in the upper left region of the abdomen. Such a feeling of fullness in the abdomen (also called bloating) may be erroneously ascribed to a full stomach.
Also, the sensation of fullness is enhanced by eating, which only serves to support the notion that a full stomach is the cause of the bloating sensation. However, the feeling of fullness in the abdomen can be caused even by a moderate level of splenomegaly.
Lightheaded or dizzy
Spleen is rich in blood supply. Therefore, a rupture of the spleen can cause a significant amount of blood loss that can disrupt the hemodynamics in the body. To counter the loss of blood, the blood vessels may begin to constrict, which reduces the flow of blood to the brain and other organs of the body. Lack of sufficient blood supply in the brain can lead to feelings of dizziness or lightheadedness.
Dizziness is a nonspecific symptom that may occur in a variety of conditions. However, if splenic injury is suspected, then one must take the situation very seriously and seek immediate medical attention. This should be done even if no other symptoms are evident.
The spleen harbors a large number of immune cells. In fact, the spleen is sometimes referred to as the largest lymph node of the body. Problems with the spleen can adversely affect the functioning of the immune system. This lowers the immunity of the body, leading to recurrent or persistent infections. These infections may not be easy to treat.
Due to its role in the destruction of old red blood cells, the spleen is sometimes referred to as the graveyard of red blood cells. Problems in the spleen can sometimes cause an increase in the destruction of red blood cells that pass through the spleen. Such an overactive spleen (medically referred to as hypersplenism) could lead to anemia, which may be characterized by low blood pressure, and paleness (or pallor) of the skin and mucus membranes.
After the red blood cells are destroyed, the liver takes up the job of removing the leftover components of red blood cells from the body. In hypersplenism, the rate of destruction of red blood cells may exceed the capacity of the liver to get rid of the breakdown products. This could lead to a buildup of the byproducts of red blood cell destruction in the bloodstream.
Bilirubin is one such substance that may begin to accumulate in the blood, mucus membranes and the skin. Accumulation of bilirubin in the skin and mucus membranes causes these tissues to exhibit a yellowish color (a condition that is medically referred to as jaundice).
Around 40% of the platelets in the body are located within the spleen. The percentage of platelets that reside in the spleen can go up to 90% in conditions such as splenomegaly. This causes a significant drop in the level of platelets in the bloodstream, which adversely affects the blood clotting process.