Enlarged spleen

Diagnosis

When you visit a healthcare provider, you might have symptoms related to your underlying condition, or you may experience generalized abdominal discomfort.
The following procedures will assist the healthcare provider in properly diagnosing an enlarged spleen:

• Physical examination: Healthcare providers may incidentally find an enlarged spleen during a routine examination or while investigating other issues. Typically, a physical examination is sufficient to identify an enlarged spleen. Often, healthcare providers can palpate it by gently pressing on the left upper abdomen. However, in some individuals, particularly those who are thin, a physical examination may reveal a healthy, normal-sized spleen.
  In order to confirm the diagnosis of an enlarged spleen, your healthcare provider might recommend the following tests:
• Blood tests: Your healthcare provider might perform blood tests, such as a complete blood count and liver function tests, to further investigate if they are uncertain about the cause of the enlarged spleen.
• Imaging test: A CT scan or abdominal ultrasound can confirm the presence of an enlarged spleen and provide further details, such as the extent of enlargement, the presence of a lesion, and whether the spleen is invading other organs. You may trace the blood flow through your spleen by an MRI.
• Bone marrow analysis: Your healthcare provider may perform a bone marrow aspiration and/or biopsy to examine the blood cell composition within your bone marrow. This procedure offers insights into the functionality of your spleen and can help identify potential disorders.

Spleen needle biopsies are uncommon due to the possibility for bleeding.

In cases where there is no apparent reason for the enlargement, your healthcare provider may suggest a splenectomy as a diagnostic procedure. The spleen is typically removed as part of treatment. Following the surgical removal of the spleen, it undergoes microscopic examination to screen for potential spleen lymphoma.

Treatment

The spleen often returns to its usual size once the underlying condition improves. Certain conditions, such as temporary infections, may resolve on their own. Your healthcare provider may use medication, blood treatments, or surgery to address further issues.

The goal of treatment for an enlarged spleen is to identify and address its cause. For example, if you have a bacterial infection, antibiotics would be part of the treatment.

If you have an enlarged spleen but no symptoms, and the cause is unknown, your healthcare provider may recommend watchful waiting. You will need to return for a re-assessment in six to twelve months or sooner if you develop symptoms.

• Surgery:
  • Spleen removal surgery: A splenectomy—the removal of the enlarged spleen through surgery—may be an option if the enlarged spleen produces significant complications or if the cause cannot be identified or treated. In severe or chronic situations, surgery may be the best course of action for recovery.
    Much consideration must be given to elective spleen removal. Without a spleen, one can lead an active life, but after having them removed, the risk of developing severe or life-threatening infections increases.
  • Preventing the risk of infection after surgery: Following spleen removal, you can prevent or lower your risk of infection by doing the following:
    • These vaccines encompass the pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib) vaccines, safeguarding against against pneumonia, meningitis, and infections of the blood, bones, and joints. Additionally, following surgery, you will require the pneumococcal vaccination every five years.
    • After surgery and if you or your healthcare provider detects an infection, take penicillin or other antibiotics.
    • Seek medical attention if you experience any indication of infection such as fever.
    • Stay clear of locations where certain diseases, including malaria, are common.