Definition

Splenomegaly is a medical condition characterized by the enlargement of the spleen, also commonly referred to as an enlarged or swollen spleen. The spleen is an organ that is part of the lymphatic system, which plays a role in the immune system by storing white blood cells and aiding in the formation of immunoglobulins or antibodies. The spleen is located on the left side of the abdomen beneath the rib cage. It also plays a role in recycling aged red blood cells and storing iron from hemoglobin. The spleen is crucial to the body as it helps fight infections since it distributes white blood cells, B cells, and T cells. White blood cells protect the body from bacterial infections and other microbial infections.

Causes

Spleen enlargement can be caused by various diseases and medical conditions, including:

• Infections, such as mononucleosis
• Liver problems, such as cirrhosis and cystic fibrosis
• Juvenile rheumatoid arthritis, which causes inflammation in the lymphatic system, including the spleen
• Malaria
• Hodgkin's disease
• Leukemia
• Heart failure
• Tumors in the spleen.
• Malignancies from other organs spread to the spleen
• Viral infections
• Bacterial infections
• Parasitic infections
• Inflammatory diseases such as lupus rheumatoid arthritis, or sickle cell disease

Risk factor

The risk factors that can increase the occurrence of splenomegaly depend on its underlying causes. Generally, patients with a family history of blood abnormality have a higher risk of developing splenomegaly.

Symptoms

Some individuals with an enlarged spleen may not experience specific symptoms. They are usually found accidentally during a physical examination or medical check-up. Individuals with low body weight or thin skin may be able to feel the enlarged spleen through the skin.

The most common splenomegaly symptoms include pain or discomfort in the upper left abdomen, where the spleen is located. You may also experience a feeling of fullness or bloating after eating small portions. This occurs because the enlarged spleen presses against the stomach. As the spleen continues to press against other organs, blood flow to the spleen can be disrupted. This can lead to disturbances in the blood filtration function within the spleen. An increasingly enlarged spleen can disrupt red blood cell production and damage the remaining red blood cells. These conditions can result in a medical condition known as anemia. The enlarged spleen also causes decreased production of white blood cells, making you more susceptible to infections.

Diagnosis

The doctor will inquire about the patient's symptoms during a medical interview. The existing symptoms can guide toward a specific disease, so it is essential to communicate the symptoms as thoroughly as possible, especially when they first start. This information is crucial for the doctor to establish a particular medical diagnosis. If the perceived symptoms point to splenomegaly, the doctor will perform a physical examination and additional tests.

During the physical examination, the doctor will conduct assessments based on the symptoms reported by the patient to identify several clinical signs, which are objective signs obtained by the doctor through physical examination. In cases of splenomegaly, the doctor may detect tenderness upon palpation in the upper left side of the abdomen.

Diagnostic tests also play a role in confirming or establishing the diagnosis of splenomegaly. Suppose there is suspicion regarding the underlying cause of splenomegaly. Additional laboratory tests such as complete blood count, liver function tests, lipase, rheumatic panels, or specific infection panels may be examined. Additionally, an abdominal CT scan can be performed if there is suspicion of abnormalities in the spleen, such as tumors or abscesses. Ultrasound (USG) examination can also help determine the spleen's size.

Management

In rare cases, injuries or trauma can rupture the spleen. If you are experiencing splenomegaly, healthcare professionals will advise you to refrain from participating in sports, especially heavy sports. Because splenomegaly can be caused by specific medical conditions or diseases, treatment will be given depending on the underlying cause. Identifying the cause is crucial in cases of splenomegaly; therefore, the treatment administered can be appropriate and tailored to the specific condition.

Complications

Complications that can arise from splenomegaly include a rupture of the spleen, a severe complication in splenomegaly cases. Splenic rupture is a condition in which the spleen tears. Additionally, cytopenia, a decrease in the number of blood cells in the blood, can also be another complication due to splenomegaly. In many cases, cytopenia can be managed or minimized by undergoing splenectomy if necessary. Splenectomy is a surgical procedure to remove the spleen.

Prevention

Currently, there is no specific and significant prevention to avoid splenomegaly. Prevention depends on the potential causes that may lead to splenomegaly. However, some general measures can reduce the risk of splenomegaly, including maintaining a balanced diet, avoiding smoking, abstaining from alcohol, engaging in regular exercise, and getting enough rest.

When to see a doctor?

Suppose you experience worsening symptoms, such as pain in the upper left side of the stomach or severe stomach pain while breathing. In that case, you should have further examinations by internal medicine specialists (Sp. PD). Doctors will conduct medical interviews, physical examinations, and certain supporting examinations to determine a definite diagnosis of the underlying disease and proper management as needed.

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