Health, Lifestyle

The spleen… step by step

Its name doesn’t reveal much and perhaps even sounds a little amusing.  It doesn’t seem to give it a lot of credit, but without a doubt, it plays an important role in our bodies. Here are some questions and answers about this organ.


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José A. de la Osa


The spleen is a single ovoid organ, situated in the upper rear quadrant of the abdomen, to the left, under the diaphragm, and its functions are grouped into four categories.

One of these is the filtration of the blood, another is immunological or defence, another is as a blood reserve and the fourth is haematopoietic; to make blood.

The first two are considered the most important and they keep going all of our lives, whereas the other two are fundamental in the foetal stage of development.

Is it susceptible to infection?

Yes, according to Doctor Abel García Valdés, chief of the General Surgery Department at the University Hospital “Calixto García” in Havana.

He goes on to say:  The identification of a palpable spleen in adults almost always indicates an underlying illness.  Not so in children, where you can find minor inflammation related to infections.

What fundamental processes or mechanisms contribute to the appearance of a disorder in this organ?

There are many pathological processes, generally systemic, that can cause, to a greater or lesser extent, an increase in the size of the spleen (splenomegaly). For example:  diseases of the blood like haemolytic disorders (the breakdown of the blood cells), lymphomas, leukaemia, benign and malignant tumours, parasitic illnesses and infections.

And what about rupturing of the spleen as a result of some kind of trauma?

The spleen is the most fragile organ in the human body.  It is therefore very susceptible to ruptures, caused by traumatic injuries of the abdomen or penetrating injuries. Therefore, operations on the spleen for these reasons are most common.

Does age or sex have an effect on the appearance of diseases in this organ?

Not regarding their frequency, but the nature of the condition is affected. Diseases with a malignant cause are more common in adults.

What signs or symptoms can alert us to any malady?

The symptoms will depend on the nature of the condition. With regard to diseases of the spleen, because of a poor condition of blood cells, an increase in the size of the organ is a very common sign.

These patients complain of pain or irritation, like a sensation of heaviness in the upper-left part of the abdomen; show signs of anaemia; fatigue easily; have frequent infections (due to a decrease in the bodily defences); and a tendency to haemorrhage (due to minor lesions in the skin and mucous membranes).

Is the diagnosis clinical or does it require further tests?
It’s fundamentally clinical.  A comprehensive history and a physical examination indicate the suspected diagnosis.  For many patients, blood tests are required to show existing changes, and ultrasound tests to ascertain the diagnosis with certainty.

Are the treatments remedial or just palliative?

This would depend on the illness that is affecting the spleen.

Which patients generally are the ones who require the removal of the spleen (splenectomy)?
Mainly patients with haemolytic illnesses (that relate to the destruction of the different types of blood cells); those in which the removal of the organ will lengthen the lifespan of the red blood cell; in exaggerated enlargement of the size of the spleen; in some malign blood disorders; for primary benign or malignant tumours of the spleen, parasitic cysts and in severe trauma wounds.

What principal symptoms does the rupture of the spleen following trauma cause?  What action should be taken?

These patients suffer, amongst other symptoms, internal bleeding, acute severe anaemia, a significant reduction of blood pressure, profuse sweating and an increase in pulse rate.  They should be taken without delay to specialist emergency centres.

Should people who have had their spleens removed take any special precautions in their day to day lives?

In the post-operative period and months (or even years later), they need to be protected from opportunistic infections because of the loss of the filtration and defence functions of the organ, therefore as soon as symptoms occur, such as fever, they should be investigated and treated promptly.

I leave this question open for any final comment…

Diseases of the spleen are treated by multidisciplinary teams of haematologists, oncologists and surgeons amongst other specialists, in a joint effort to achieve better health for these patients.

(Translated by Christopher Hill – c.hill.08@aberdeen.ac.uk)

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