An enlarged spleen, or as doctors say, splenomegaly, is a rather alarming symptom with which doctors go. The spleen is an important organ, but ordinary people think little about its purpose. We can say that this is a kind of filter of the blood that eliminates infections, antibodies, old red blood cells, controls the number of platelets, etc. The spleen is also involved in immunological protection, and at the same time is the largest node of the lymphatic system.
Normally, the body has the shape of a bean, small in size, about 11 cm in an adult, and weighs about 150 to 200 grams. The spleen itself can not hurt, for example, like a liver, but if it grows in size, then immediately there will be a feeling of discomfort in the left hypochondrium.
Why can the spleen be enlarged?
It is possible to speak about true enlargement of the spleen if the mass of the organ is more than 600 g. At the same time, it can be easily felt in the left half of the abdomen in the subcostal area. Due to the large-scale list of functions, an increase in this body can occur for many reasons. Therefore, to unequivocally answer the question: why is the spleen enlarged? - pretty hard. Such a wide variety of reasons is usually classified according to the mechanism of development of an increase.
One of the most common causes of an enlarged spleen is the so-called "working hypertrophy", which is formed as an immunological response to acute, subacute and chronic and infectious diseases.
When antigens enter the body, an immune response begins, in which the spleen is actively involved. During the body's defense, an increase in its blood supply occurs, and, accordingly, the mass of cells increases, which is located in the spleen. It is in this way that an increase in the organ occurs in viral hepatitis, toxoplasmosis, or cytomegalovirus. Septic conditions, serum sickness, tuberculosis and systemic lupus erythematosus can also be included in this list.
In the spleen, the physiological breakdown of “old” blood cells occurs, which have already outlived their time. But in the case of any pathology, which is characterized by an increase in the number of broken blood cells, a regular increase in the organ begins. And this circumstance unites in itself the 2nd group of causes of splenomegaly.
Such a scenario of organ enlargement is characteristic of some types of anemia (sickle cell, hemolytic, etc.), some autoimmune diseases with the destruction of leukocytes, platelets. Even with hemodialysis, splenomegaly may develop.
In the spleen, the venous network is very well developed, and if the outflow of venous blood is disturbed, for example due to blood clots, the organ can increase significantly in size - this is congestive splenomegaly. In addition, blood stasis in the spleen can occur in conditions that can lead to an increase in pressure in the portal, splenic veins. These large veins can be compressed by a tumor of the abdominal cavity, or their lumen can be blocked by a thrombus. In rare cases, chronic heart failure can be the cause of congestive splenomegaly.
Causes of pathology in children:
- In children, there is a physiological increase in the spleen on days 2–3 of life, which depends on the fullness of the organ in the blood. This organ can also be palpated in babies with rickets and rickets-like conditions.
- Like adults, an enlargement of the spleen is characteristic of some infectious diseases, and some diseases of internal organs - disorders of blood circulation in the portal vein, congenital heart defects, some types of anemia, etc.
When symptoms of spleen enlargement appear, it is necessary to consult a specialist as soon as possible - a gastroenterologist, a hematologist and an oncologist. Based on the clinical situation and complaints, it will be necessary to undergo a series of studies - laboratory tests, CT, ultrasound, etc. Sometimes additional blood tests are necessary, with the help of which it will be possible to determine the disorders of blood formation and blood composition, as well as liver function. According to the results of tests and research, the reason for the spleen enlargement will be revealed.
Specific treatment will depend precisely on the root cause of splenomegaly, aimed at treating the underlying disease, such as treating an infection, reducing pressure in the veins, treating neoplastic processes, etc. In quite rare cases, but splenectomy is performed — spleen removal. This operation is necessary only when it is not possible to restore the function of the spleen, and it begins to remove not only old and bad blood cells, but also healthy ones. Also, the indication for removal may be the lesion of an organ with cancer cells.
After removal of the spleen, the immune defense function is significantly reduced, and the patient becomes sensitive to pneumococcus, meningococcus and hemophilic bacilli. For these reasons, vaccinations against relevant infections are mandatory.
To diagnose an increase in the spleen in the early stages is quite difficult, because there is no pain, and the pressure appears only with a significant increase. For these reasons, it is rarely possible to detect serious diseases in a timely manner and take appropriate measures. Universal advice for patients, especially in the prevention of splenomegaly, is regular visits to doctors and preventive examinations.