What happens when the spleen is enlarged ?
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Q- What happens when the spleen is enlarged ?
Spleen is an important organ of the lymphatic system. It is found on the left upper side of the abdomen, between the 9th and 12th rib. The primary function of the spleen is to produce lymphocytes and plasma cells, which are used in humoral and cellular immune defense. Approximately half of the body’s monocytes are stored in this organ. These cells can easily transform into macrophages and dendritic cells, and assist in wound repair. Additionally, the spleen filters the blood and removes all the unwanted materials like cell debris and microorganisms as bacteria, viruses and fungi.
Furthermore, it monitors the red blood cells, eliminating those that are abnormal, damaged or too old to function properly. It also serves as a storehouse for various elements of the blood like platelets and white blood cells. In the absence of the spleen, the body becomes susceptible to diseases caused by bacteria and protozoa, and responsiveness to certain vaccines also decreases. Whenever the normal functioning of the body is hampered by disorders like cancer, anemia, malaria, tuberculosis, amyloidosis, cirrhosis, hepatitis and the like, the spleen becomes hyperactive, and starts entrapping and storing a large number of blood cells and platelets.
As the result, the platelet and blood cell count in the bloodstream begins to fall dramatically. Due to entrapment, the spleen grows in size, and as it grows, it traps in more and more blood cells and platelets. Eventually the overgrown spleen starts capturing and destroying the normal blood cells together with the abnormal ones. These blood cells and platelets clog the spleen and interfere with its normal function.
The characteristic symptom of spleen enlargement is severe pain in the abdomen and back. At times, the pain shoots up to the left shoulder. This happens when certain parts of the spleen begin to bleed and die due to inadequate supply of blood. The enlarged spleen also starts pressing the stomach, which leads to the feeling of fullness after eating a small amount of food or even without eating anything. Furthermore, as too many blood cells and platelets have been removed from the bloodstream, the body’s immune response begins to dwindle, symptoms of anemia emerge, and normal blood clotting process is also slows down.
Symptoms of an Enlarged Spleen
Most people don't know they have an enlarged spleen because symptoms are rare. People usually find out about it during a physical exam. These are the most common symptoms of an enlarged spleen:
Being unable to eat a large meal
Feeling discomfort, fullness, or pain on the upper left side of the abdomen; this pain may spread to your left shoulder
If you have pain that is severe or gets worse when taking a deep breath, see your doctor right away.
If you have an enlarged spleen, you may develop other signs or symptoms, too. These are related to the underlying disease. They may include signs and symptoms such as:
Your doctor will ask you questions and do a physical exam to diagnose an enlarged, painful spleen. This involves palpating (examining by touch) your spleen. You will also likely need diagnostic tests to confirm the cause of the swollen spleen. These may include blood tests, an ultrasound, or computerized tomography (CT) scan. In some cases, other tests may be needed.
Spleen Geography 101:.
A part of the lymphatic system, the dark purplish spleen lies in the upper left abdomen protected by the lower ribs. (Our unscientific, people-on-the-street survey suggests wide gaps in anatomy knowledge. "Where is the spleen?" was met with, "Uh, it's somewhere in the main part of the body--not in the extremities.")
My, What a Fine Looking Spleen:
Size and weight can vary greatly, but in healthy adults the spleen is often about 5 inches long by 3 inches wide and 1 1/2 inches thick. A typical spleen weighs in at about 6 ounces in a healthy adult. But when it becomes enlarged--from malaria or other diseases--it can weigh a hefty 4 pounds or so.
They're Not Just for Venting:
Not that you've noticed, but the spleen is a busy little part. Its main tasks are to remove worn-out and damaged red blood cells and platelets and to help the body fight off infection.
It filters foreign substances from the blood and produces white blood cells called lymphocytes, which help boost immunity.
Whose Spleen Is It, Anyway ?
Spleens are handled by internists, though hematologists (physicians specializing in blood and blood-producing organs) and oncologists (physicians specializing in tumors) also provide spleen care, depending on the exact problem.
Spleens Gone Bad:
So what can go wrong with the spleen? It can get too big, sometimes producing a soreness. Besides malaria, a host of other disorders are accompanied by enlargement of the spleen. A partial list:
infectious mononucleosis, chronic liver problems, rheumatoid arthritis, lupus, the early stages of AIDS. In sickle cell anemia patients, the spleen enlarges and then patients lose spleen function, says Dr. Andrew Saxon, professor of medicine and chief of the division of clinical immunology at UCLA.
Patients with Gaucher's disease (a disorder of fat metabolism) have enlarged spleens, as do people with lymphomas and people with idiopathic thrombocytopenic purpura (ITP), a systemic illness marked by low platelet counts, weakness and anemia.
The spleen can also get ruptured in car accidents, falls or stabbings.
If the spleen is injured seriously, or otherwise causes too much trouble, it's likely to get yanked, although in some instances it is repaired.
Yes, you can live a full life without your spleen.
About 1% of the population is spleenless, estimates Dr. Lawrence May, an internist at Encino-Tarzana Medical Center.
Among the spleenless is talk show host Jay Leno. In his book "Leading With My Chin" (HarperCollins, 1996), he describes his childhood trip down the banister that ended at the hospital, where he and his spleen parted company.
The spleen's tasks are largely taken over by other parts of the lymphatic system and the liver. Oddly, some people--no one's quite sure how many--have a spare spleen. An accessory spleen, as it's known, is not rare, Saxon says.
Spleened Versus Spleenless:
"On paper, spleenless is not as good as someone who has a spleen," Saxon says, referring to overall health. "They are more susceptible to infection," he says. Those who have lost a spleen to rupture are generally healthier than those who are spleenless due to lymphoma, for instance, Saxon notes.
Folks without a spleen should take some precautions, experts concur.
Get vaccinated against pneumonia and always alert a new doctor or dentist to your condition. When fever strikes, people without a spleen can get sicker quicker, May says.
And dentists may want to take extra precautions to minimize infection risks, says Dr. Eric Sung, a dentist and program director of the UCLA hospital dentistry program.
People without spleens might also want to note that fact on a medical information bracelet