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Spleen: Function, Location & Problems

By
Jessie Szalay - Live Science Contributor
April 05, 2018

 

The spleen is located on the left side of the abdomen, under the ribs.
(Image credit: <a href="http://www.shutterstock.com/gallery-65904p1.html">Sebastian Kaulitzki</a> | Shutterstock )

The spleen is the largest organ in the lymphatic system. It is an important organ for keeping bodily fluids balanced, but it is possible to live
without it.

The spleen is located under the ribcage and above the stomach in the left upper quadrant of the abdomen. A spleen is soft and generally
looks purple. It is made up of two different types of tissue. The red pulp tissue filters the blood and gets rid of old or damaged red blood
cells. The white pulp tissue consists of immune cells (T cells and B cells) and helps the immune system fight infection.

Size

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According to Medical News Today, a helpful tip to remember the size of the spleen is the 1x3x5x7x9x11 rule:
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An adult spleen measures around 1 inch by 3 inches by 5 inches.
It weighs around 7 oz.
It is located between the 9th and 11th ribs.

Function
"The spleen . . . acts as a blood filter; it controls the amount of red blood cells and blood storage in the body, and helps to fight infection,"
said Jordan Knowlton, an advanced registered nurse practitioner at the University of Florida Health Shands Hospital. If the spleen detects
potentially dangerous bacteria, viruses, or other microorganisms in the blood, it — along with the lymph nodes — creates white blood cells
called lymphocytes, which act as defenders against invaders, according to the U.S. National Library of Medicine. The lymphocytes produce
antibodies to kill the foreign microorganisms and stop infections from spreading.

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According to the Children’s Hospital of Pittsburgh of UPMC, when blood flows into the spleen, red blood cells must pass through narrow
passages within the organ. Healthy blood cells can easily pass, but old or damaged red blood cells are broken down by large white blood
cells. The spleen will save any useful components from the old blood cells, including iron, so they can be reused in new cells. The spleen
can increase in size in order to store blood. The organ can widen or narrow, depending on the body's needs. At its largest, the spleen can
hold up to a cup of reserve blood.

Spleen problems

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Some problems associated with the spleen are:

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Lacerated spleen or ruptured spleen

According to Knowlton, spleen lacerations or ruptures "usually occur from trauma (like a car accident or contact sports)." These emergency
situations cause a break in the spleen's surface and can lead to "severe internal bleeding and signs of shock (fast heart rate, dizziness, pale
skin, fatigue)," said Knowlton. The Mayo Clinic reported that without emergency care, the internal bleeding could become life-threatening. 

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On the continuum of spleen breakage, a laceration refers to a lower-grade extent of injury, in which just a part of the spleen is damaged. A
ruptured spleen is the highest grade of broken spleen injury, according to HealthTap, an online network of doctors who answer health
questions.

According to Medical News Today, symptoms of a lacerated or ruptured spleen include pain or tenderness to the touch in the upper left
part of the abdomen, left shoulder and left chest wall, as well as confusion and lightheadedness. If you experience any of the symptoms
after a trauma, seek emergency medical attention immediately. 

Treatment options depend on the condition of the injury, according to the Mayo Clinic. Lower-grade lacerations may be able to heal
without surgery, though they will probably require hospital stays while doctors observe your condition. Higher-grade lacerations or
ruptures may require surgery to repair the spleen, surgery to remove part of the spleen, or surgery to remove the spleen completely.

Humans can live without their spleen, but those without one may be more susceptible to infection. More on that, below. [What Organs Can
You Live Without?]

Enlarged spleen

An enlarged spleen, also called a splenomegaly, is a serious but typically treatable condition. "An enlarged spleen puts one at risk for
rupture," said Knowlton. According to the Mayo Clinic, anyone can get an enlarged spleen, but children suffering from mononucleosis,
adults with certain inherited metabolic disorders including Gaucher's and Neimann-Pick disease, and people who live or travel to malaria-
endemic areas are more at risk. 

Knowlton listed infection, liver diseases, cancer, and blood diseases as typical causes for enlarged spleens. According to the Mayo Clinic,
specific infections and diseases include:

viral infections, such as mononucleosis

bacterial infections
parasitic infections, such as malaria
metabolic disorders
hemolytic anemia
liver diseases, such as cirrhosis
blood cancers and lymphomas, such as Hodgkin's disease
pressure on or blood clots in the veins of the liver or spleen

In many cases, there are no symptoms associated with an enlarged spleen, according to the University of Maryland Medical Center.
Doctors typically discover the condition during routine physicals because they can feel enlarged spleens. When there are symptoms, they
might include:

pain in the upper left abdomen that may spread to the shoulder
fatigue
anemia
bleeding easily
feeling full without eating

Typically, enlarged spleens are treated by addressing the underlying problem, according to the Mayo Clinic. If the cause of the enlarged
spleen can't be determined or if the condition is causing serious complications such as a ruptured spleen, doctors may suggest removing

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the spleen.
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Spleen cancer

Cancers that originate in the spleen are relatively rare. When they do occur, they are almost always lymphomas, blood cancers that occur
in the lymphatic system. Usually lymphomas start in other areas and invade the spleen. According to the National Cancer Institute, adult
non-Hodgkin lymphoma can have a spleen stage. This type of spleen invasion can also happen with leukemia, blood cancer that originates
in bone marrow. Rarely, other types of cancers — like lung or stomach cancers — will invade the spleen.

Spleen cancer symptoms may resemble a cold or there may be pain or fullness in the upper abdomen. An enlarged spleen can also be the
result of spleen cancer.

Treatment for spleen cancer will depend on the type of cancer and how much it has spread. The National Cancer Institute lists spleen
removal as a possible treatment. 

Spleen removal

Spleen removal surgery is called a splenectomy. Knowlton said that the procedure is done in cases such as: "trauma, blood disorders
(idiopathic thrombocytopenia purpura (ITP), thalassemia, hemolytic anemia, sickle cell anemia), cancer (lymphoma, Hodgkin disease,
leukemia), and hypersplenism to name a few."

Spleen removal is typically a minimally invasive laparoscopic surgery, according to the Cleveland Clinic, meaning that surgeons make
several small incisions and use special surgical tools and a small camera to conduct the surgery. In certain cases, a surgeon may opt for
one large incision, instead.

"You can live without a spleen because other organs, such as the liver and lymph nodes, can take over the duties of the spleen," said
Knowlton. Nevertheless, removing the spleen can have serious consequences. "You will be more at risk to develop infections," said
Knowlton. Often, doctors recommend getting vaccines, including a pneumococcus vaccine, Haemophilus B vaccine, Meningococcal vaccine,
and yearly flu vaccine after a splenectomy, according to University of Michican Hospitals and Health Centers. It is important to see a doctor
at the first sign of infection if you do not have a spleen.

Additional reporting by Alina Bradford, Live Science contributor.

Editor's Note: If you’d like more information on this topic, we recommend the following book:

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Additional Resources

Medical News Today: The Spleen- Anatomy, Function and Disease

Merck Manual: Overview of the Spleen
Encyclopedia Britannica: Spleen
National Library of Medicine: Spleen

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