ZocdocAnswersWhat are the symptoms of an enlarged spleen?

Question

What are the symptoms of an enlarged spleen?

During a physical with my doctor this week, he paid special attention to my side, then said I had an enlarged spleen. Is it true there aren't symptoms of an enlarged spleen? If so, if it's not causing problems for me, why do we have to treat it at all?

Answer

An enlarged spleen is a physical sign, rather than a specific diagnosis. The real question is "why is your spleen enlarged?" The spleen is an immune organ that carefully samples your blood for infected cells and helps clear aging blood cells. It can be enlarged in response to an infection (like mono), but it can also be enlarged in certain blood cancers. It can also get big simply from a backflow of pressure building up in the liver, as in cirrhosis. The large spleen itself can cause a couple of problems. It can sequester your blood cells (particularly platelets) from your circulation, making you more likely to bleed from small cuts. It can also rupture and bleed itself, as it expands below your protective ribcage. It can also be totally without symptoms As each individual person is different, your doctor will evaluate you with whatever tests he thinks are necessary, based on the most likely explanation for your enlarged spleen. If you are not having concerning symptoms and your basic blood work is normal, he may choose not to act at all, but may just follow you over time. In the big picture, your enlarged spleen should be thought of more as a possible sign of something else going on (which could be nothing more than an asymptomatic viral infection), rather than a specific disease that needs to be treated. However, your doctor knows you best, and should be able to explain his reasoning and concerns as he makes decisions based on the enlarged spleen.

This answer is for general informational purposes only and is not a substitute for professional medical advice.

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