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Spleen: Function, Location & Problems

abdomen, spleen
The spleen is located on the left side of the abdomen, under the ribs.
Credit: Sebastian Kaulitzki | Shutterstock

The spleen is the largest organ in the lymphatic system. It is located under the ribs and above the stomach on the left side of the abdomen. Adult spleens are usually about 5 inches wide and weigh about 6 ounces. Spleens are soft and purple, possessing many blood vessels.

While the spleen is an important organ for keeping bodily fluids balanced, it is possible to live without it.

Function

The spleen’s primary functions are to filter and purify blood and store blood cells. It can filter out any foreign or potentially dangerous bacteria or viruses in the blood. This helps ward off infection and fight germs as well as regulate the amount of blood in the body.

When blood flows into the spleen, red blood cells must pass through narrow passages within the organ. Healthy blood cells can easily pass but old or damaged red blood cells are broken down by large white blood cells. The spleen will save any useful components from the old blood cells, including iron, so they can be reused in new cells.

If the spleen detects potentially dangerous bacteria, viruses, or other microorganisms in the blood, it — along with the lymph nodes — creates white blood cells called lymphocytes that act as defenders against invaders. The lymphocytes produce antibodies to kill the foreign microorganisms and stop infections from spreading.

The spleen can increase in size in order to store blood. The organ can widen or narrow, depending on the body’s needs. At its largest, the spleen can hold up to a cup of reserve blood.

[Infographic: Diagram of the Lymphatic System]

Spleen problems

Some problems associated with the spleen are:

Lacerated spleen or ruptured spleen

Spleen lacerations or ruptures are emergency situations brought on by trauma to the abdomen, such as a car crash, that cause a break in the spleen’s surface. This problem, also known as a splenic rupture, can also be brought on by an enlarged spleen.

On the continuum of spleen breakage, a laceration refers to a lower-grade extent of injury, in which just a part of the spleen is damaged. A ruptured spleen is the highest grade of broken spleen injury.

Lacerated or ruptured spleens can cause serious problems. Without proper emergency care, they can lead to life-threatening internal bleeding.

Symptoms of a lacerated or ruptured spleen include pain or tenderness to the touch in the upper left part of the abdomen, confusion and lightheadedness. If you experience any of the symptoms after a trauma, seek emergency medical attention immediately.

Treatment options depend on the condition of the injury. Lower-grade lacerations may be able to heal without surgery, though will probably require hospital stays. Higher-grade lacerations or ruptures may require surgery to repair the spleen, surgery to remove part of the spleen, or surgery to remove the spleen completely.

Enlarged spleen

An enlarged spleen, also called a splenomegaly, is a serious but typically treatable condition. Anyone can get an enlarged spleen, but children suffering from mononucleosis, adults with certain inherited metabolic disorders including Gaucher’s and Neimann-Pick disease, and people who live or travel to malaria-endemic areas are more at risk. Enlarged spleens can encourage the risk of infection in the body and the risk of splenic ruptures.

There are several diseases associated with enlarged spleens, which can contribute to causing the condition. They include:

  • viral infections, such as mononucleosis
  • bacterial infections
  • parasitic infections, such as malaria
  • metabolic disorders
  • hemolytic anemia
  • liver diseases, such as cirrhosis
  • blood cancers and lymphomas, such as Hodgkin's disease
  • pressure on or blood clots in the veins of the liver or spleen

In many cases, there are no symptoms associated with an enlarged spleen. Doctors typically discover the condition during routine physicals because they can feel enlarged spleens. When there are symptoms, they might include:

  • pain in the upper left abdomen that may spread to the shoulder
  • fatigue
  • anemia
  • bleeding easily
  • feeling full without eating

Typically, enlarged spleens are treated by addressing the underlying problem. If the cause of the enlarged spleen can’t be determined or if the condition is causing serious complications such as a ruptured spleen, doctors may suggest removing the spleen.

Spleen cancer

Cancers that originate in the spleen are relatively rare. When they do occur, they are almost always lymphomas, blood cancers that occur in the lymphatic system. Usually lymphomas start in other areas and invade the spleen. This type of spleen invasion can also happen with leukemia, blood cancer that originates in bone marrow. Rarely, other types of cancers--like lung or stomach cancers--will invade the spleen.

Spleen cancer symptoms may resemble a cold or there may be pain or fullness in the upper abdomen. An enlarged spleen can also be the result of spleen cancer.

Treatment for spleen cancer will depend on the type of cancer and how much it has spread.

Spleen removal

Spleen removal surgery is called a splenectomy. It is typically done in the case of a ruptured spleen, blood disorders such as sickle cell anemia, cancer, infection, or to remove a cyst or tumor. In all cases, it is usually a last resort. [Related: What Organs Can You Live Without?]

Spleen removal is typically a minimally invasive laparoscopic surgery, meaning that surgeons make several small incisions and use special surgical tools and a small camera to conduct the surgery. In certain cases, a surgeon may opt for one large incision, instead.

Though it is possible to live without the spleen, removing it can have serious consequences. Without the spleen, you are more likely to contract serious infections. Sometimes doctors recommend getting pneumonia and flu vaccines and taking preventive antibiotics before spleen removal surgery. After the spleen is removed, other organs, including the liver, will take over the spleen’s function, but it is still important to see a doctor at the first sign of infection if you do not have a spleen.

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