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Spleen – function, location, problems

Spleen is an organ situated in the abdominal cavity. Throughout the twentieth century, it was thought to be a mystery organ as its functionality was not understood. As per the ancient Greek doctors, spleen was instrumental in the production of ‘black bile’ which was one of the ‘four humors’ that maintained the balanced functionality of the body.

Excess production of this black bile was thought to cause depression or melancholia. The traditional Chinese physicians thought that spleen was responsible for temperament and will power. As of today, doctors are aware of the functions of spleen. It has become a part of the lymphatic system.

Spleen has come to be recognized as one of the most important organs of the body. It is present in almost all types of vertebrate animals and the name is derived from the Greek word ‘Splen’. It is an essential part of the immune system. It supplies blood at the time of emergencies and assists in ridding the body of old blood cells.

Structure and location of the spleen

The spleen can be considered as a ductless gland that is really small in size, similar to a closed fist. It is situated in the upper left side of the abdominal cavity, below the diaphragm and just behind the stomach. The ribs cover it and hence one cannot feel or see it. Its precise location is close to the 9th, 10th and 11th rib. In its normal state it is 7 x 5 x 2 inches in size. The spleen size varies as per the individual, but its average measurement is about 4 inches in an adult with the approximate weight being 0.44 lbs.

When the spleen becomes infected, it enlarges in size and leads to several problems. Such problems of the spleen are discussed below in detail.

There is a cover of strong connective tissue capsule over the spleen. The capsule consists of two types of tissues called the white pulp and the red pulp. Lymphoid tissue such as lymphocytes plasma cells and lymphatic nodules make up the white pulp, while the red pulp consists of blood. The red pulp carries out the function of filtering blood. Both the types of pulps are evenly distributed throughout the spleen, with each having a unique set of functions. The splenic artery provides the passage of blood into the spleen.

Functions of the spleen

As discussed above, there are two types of tissues in the human spleen, the red pulp and the white pulp. Spleen contains white blood cells or lymphocytes and macrophages. These help in fighting off any invasion of bacteria from the body and also help in disposing foreign matter, dead tissues and other unwanted substances from the blood stream. Each type of tissue has distinct functions which are discussed below:

  • The red pulp consists of reticular fibers and blood. It performs the vital function of filtering the blood of all the impurities, redundant dead cells and other matter that has degraded.
  • The white pulp is also known as malpighian bodies or lymphoid nodules of the spleen. They are abundant in lymphocytes and hence are vital to the immune system functions. Such functions include getting rid of cells infected by bacteria and defending the body against infections. The spleen and other glands present in the lymph nodes recognize any attack from bacteria or viruses and instantly activate to counter their effects. The spleen produces lymphocytes that secrete antibodies which kill and destroy the viral and bacterial cells. The infection is thus curbed and then eventually destroyed by the macrophages, which engulf them.
  • The spleen has no specific digestive functions. It does store blood and supplies this additional blood to the body in times of emergency, injury or trauma. Additionally, it stores iron as ferritin that is obtained from the obliterated blood cells. Such iron is then used by the bone marrow to manufacture red blood cells.
  • Other than these major functions, the spleen performs a number of other functions. It manufactures red blood cells for the fetus, before it is born as a baby. This activity is then taken over by the bone marrow, once the baby is born. It stores additional quantities of platelets which assist in the clotting of blood, when needed. It even stores monocytes, a component of white blood cells, which assist in the healing process of injured tissues.

It is important to note that even though the spleen performs a number of vital functions, its presence in the human body is not absolutely essential. In case, the spleen is removed from the body due to medical reasons such as tumors, then its functions can easily be carried out the liver and other organs.

Problems with the spleen

Some of the conditions that affect the spleen are as follows:

  • An enlarged spleen can be caused due to viral infections, blood cancers, liver disease and other such disorders
  • A spleen may rupture immediately after an injury or a few weeks after. A ruptured spleen can lead to intense internal bleeding which can be fatal
  • It can also store excess platelets leading to thrombocytopenia
  • It can also be affected by sickle cell anemia which results in blockage of blood flow causing organ damage.
  • Sometimes, individuals may have two spleens which cause no problems.

Enlarged Spleen

There are a number of reasons for an enlarged spleen. It is not a case of undue worry, but an enlarged spleen may become overactive which can result in destruction of blood cells.

Symptoms of an enlarged spleen

  • Unable to intake large amounts of food
  • Pain in the upper left side of abdomen. This pain may radiate from the abdomen to the back and shoulders, which may indicate a swollen spleen as well. Children may also feel fullness and discomfort
  • Loss of weight and easy bleeding
  • Loss of ability to actively fight infection
  • Increased risk to anemia and jaundice
  • Unexplained fatigue

Causes of enlarged spleen

  • Bacterial and viral infections can cause spleen enlargement
  • Presence of cancers and inflammatory conditions
  • Other causes include injury and the presence of cysts

Treatment of enlarged spleen

  • The affected individual has to limit or stop physical activities to prevent spleen rupture
  • Intake of prescription medications as advised by the doctor
  • In extreme cases, the spleen may be removed via surgery

Ruptured Spleen

The spleen is protected by a covering of splenic capsule. When this capsule is damaged, it can result in spleen rupture.

The spleen can rupture due to a hard blow to the chest area or the abdomen, or from contact sports or from accidents. The spleen may rupture immediately after the trauma or a few weeks after.

An enlarged or swollen spleen can also result in spleen rupture. An enlarged spleen causes the protective layer to get stretched and thus rupture.

Symptoms of ruptured spleen

  • Tenderness and pain in the abdominal area where the spleen is present. Pain intensity varies as per spleen damage. The pain may sometimes spread to the shoulders.
  • Drop in blood pressure due to extreme internal bleeding
  • Other symptoms include confusion, paleness, restlessness, blurred vision, anxiety, fainting and lightheadedness

Treatment of spleen rupture

  • Hospitalization is required to treat spleen rupture. Depending on the cause of spleen pain, the spleen rupture issue may be treated with medications and blood transfusion to replenish the lost blood.
  • In extreme cases of spleen rupture surgery may be required.
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