Enlarged Spleen (Splenomegaly) (cont.)

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What is the treatment for an enlarged spleen?

Treatment for an enlarged spleen is usually directed at the underlying medical condition that resulted in the splenomegaly. Depending on the underlying problem, treatments can be with antibiotics, chemotherapy, or radiation. These treatments are for the underlying disease and may allow the spleen to reduce in size; however, in some cases, the spleen will remain enlarged.

On occasion, the spleen may need to be removed surgically (splenectomy = spleen + ectomy=removal) as part of the disease treatment. For example, in hereditary spherocytosis, removing the spleen prevents the anemia that occurs when the abnormally shaped red blood cells are continually being filtered out and removed from the blood stream.

What are the complications of an enlarged spleen?

When the spleen enlarges, it loses some of the protective covering of the lower rib cage and becomes more vulnerable to injury. The enlarged spleen is fragile and can be damaged with relatively minor blows to the upper abdomen. It is a relatively solid organ and can fracture or crack causing significant and potentially life-threatening bleeding.

The enlarged spleen can also trap an excessive number of blood cells within it causing:

  • anemia (decreased numbers of red blood cells), which may lead to weakness, shortness of breath, and easy fatigue;
  • leukopenia (decreased white blood cells), which may lead to increased risk of infection; and
  • thrombocytopenia (decreased platelets), which may lead to infection or to bleeding problems.

If the spleen needs to be removed, there is an increased risk of infection, especially due to bacteria such aspneumococcus (Streptococcus pneumoniae), Hemophilus influenza, and meningococcus (Neisseria meningitides). It is important to consider keeping immunizations (particularly the pneumococcal vaccine) current in patients whose spleen has been removed.

Medically Reviewed by a Doctor on 12/2/2013

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