Spleen Pain

The spleen is the largest lymphatic organ, purple in colour, lying anteriorly on left side of abdomen close to stomach, inside rib cage. It is protected by splenic capsule, which prevents it from direct injury.

Functions of spleen

White blood cells present in spleen, engulf bacteria, fights against foreign particle, defend body against infections and maintain red blood cells, white blood cells and platelets. Platelets help in blood coagulation. Spleen filters blood and removes unwanted cells from blood stream.

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Spleen pain

Spleen pain is difficult to detect due to its close location with, left kidney, stomach, abdominal wall etc. Its distinguishing feature is that it increases during deep inspiration and sneezing. During heavy meal, when the stomach is completely full, the pain is felt.

Location of spleen pain

spleen pain location

Spleen lies near 9th and 11th ribs; under the rib cage. Pain originates from the left abdomen and passes through shoulder, mid back, umbilicus, left side of chest. When the spleen becomes enlarged and extends below the costal margin, the spleen can be felt on the antero-lateral side of the abdomen and it’s superficially lying notched borders makes it distinctly accessible. Mild to moderated enlarged spleen, rarely causes pain, but if remarkable splenomegaly occurs, it is really painful. During extreme splenomegaly spleen can be felt below 8 cm costal margin and extends towards umbilicus.

Causes of spleen pain

  1. Splenomegaly (enlarged spleen)

It is a common cause of spleen pain. An enlarged spleen is not always problematic. Sometimes the spleen becomes hyperactive at removing red blood cells. This condition is known as hypersplenism. Other illness which causes spleen pain is-

  • Viral infection such as viral fever also called viral mononucleosis

Virus attacks blood and spreads this disease. Initially its symptoms are similar to common cold and fever. It attacks spleen causing it to swell. The upper part of abdomen becomes tender to touch and painful feeling appears. Tonsil is the most common example of this, which affects throat.

  • Cirrhosis and other liver disease

Cirrhosis patients have enlarged spleen. There occurs an obstructed flow of blood in portal vein, which increases pressure in spleen and causes spleen to enlarge. Enlarged spleen traps platelets causing thrombocytopenia mostly found in cirrhosis patients.

  • Infection caused by parasite (toxoplasmosis)

Toxoplasmosis is a parasitic disease, caused by a protozoan, which infects first animals then humans. It causes swelling of lymphatic organ especially spleen causing pain.

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  • Infection caused by bacteria (endocarditis)

Endocarditis occurs if bacteria, fungi attack the blood stream. People suffering from long term endocarditis, their spleen enlarges and may also get damaged.

  • Inflammatory diseases like sarcoidosis and rheumatoid arthritis

Sarcoidosis is an inflammatory disease, in which granules are formed forming lumps in spleen resulting in its inflammation and enlargement. Similarly rheumatoid arthritis affects spleen and damages its defence mechanism.

  • Blood cancer including lymphoma and leukaemia

Spleen cancer is rare. Lymphoma is a cancer generally occurs in spleen. Lymphoma undergoes metastasis. It starts in other area but invades spleen. Lung or stomach cancer also invades spleen.Lukemia is a type of cancer which originates in bone marrow but invades spleen. Symptoms of spleen cancer resemble common cold, pain or fullness in upper abdomen. Enlarged spleen may also be due to spleen cancer.

  • Sickle cell anaemia

It is a genetic disorder rapidly inherited. Abnormal red blood cells inhibit the blood flow in vessels and some body organs including spleen. A person with such type of disorders whose spleen becomes functionless needs immunisation, as they are more susceptible to illness.

  • Infiltrative diseases like gausher’s disease or glycogen storage disease.

Fat is broken down in the body, to release energy. Problematic situation arises, when enzyme is not able to break fat, so it accumulates in spleen causing its enlargement.

  • Abscesses or cysts.

Abscess or cyst can occur in spleen due to bacteria, fungi or protozoan or may be due to some illness. It disturbs spleen function causing its swelling.

Symptoms of an enlarged spleen

  • Feeling of discomfort in eating heavy meal
  • Feeling of pain or fullness in the upper left side of abdomen. Pain radiates from the abdomen to the left shoulder
  • Weight loss
  • Fatigue
  • Frequent infections
  • Quick bleeding
  • Jaundice
  • Anaemia

Splenic infarct

Death of splenic tissue due to blockage in splenic artery is called splenic infarct. Oxygenated blood is unable to reach spleen causing ischemia and finally infarct.

Spleen rupture

Rupture of splenic capsule by force or violence, resulting in bleeding in upper abdominal area. Spleen is vulnerable to injury.

Its causes may include Car accident, bike accident, sports injury like judo or boxing, colonoscopy etc.

Symptoms of ruptured spleen

  • Blurred vision
  • Headache
  • Confusion
  • Fainting
  • Shock
  • Anxiety
  • Nausea
  • Paleness

Sudden drop in blood pressure and increased heartbeat is the indication that condition is severe and emergency treatment is necessary. Doctor consultation is must in this case.

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