The spleen is a small but vital organ located in the upper-left side of the abdomen, tucked beneath the ribcage and above the stomach. Roughly the size of a closed fist and weighing between 5 to 7 ounces, this reddish-purple organ plays a crucial role in both the circulatory and immune systems. Despite its importance, many people are unaware of the spleen’s functions, or how to maintain its health.

Anatomy and Location of the Spleen

The spleen resides between the ninth and eleventh ribs and lies adjacent to the diaphragm and stomach. It's surrounded by other key organs, including the liver's left lobe, the left kidney, and the pancreas. Structurally, the spleen is spongy and divided into small sections known as lobules. Its outer layer, a soft connective tissue, allows it to expand when needed.

Interestingly, some people are born with anatomical variations. A few may have extra splenic tissue, called accessory spleens. In rare cases, individuals may be born without a spleen (asplenia), have multiple small spleens (polysplenia), or a condition known as a wandering spleen where the organ shifts abnormally within the abdomen.

What the Spleen Does

The spleen is central to immune function and blood management. It acts as a filter, removing old and damaged blood cells, and also plays a key role in fighting infections. Two types of tissue in the spleen handle these responsibilities:

  • Red pulp: This part filters blood, removes old or damaged red blood cells, and destroys microorganisms like viruses or bacteria. It also stores white blood cells and platelets.

  • White pulp: It generates white blood cells and supports the development of antibodies.

Despite being the largest organ in the lymphatic system, it's possible to live without a spleen. When removed, other organs compensate for its role, though the individual may become more susceptible to infections.

Conditions Affecting the Spleen

Several health issues can impair spleen function, either enlarging the organ or compromising its activity.

Enlarged Spleen (Splenomegaly)

An enlarged spleen can result from various infections, blood cancers, liver diseases, or autoimmune disorders. It may cause discomfort, pain, or a sensation of fullness. Conditions linked to splenomegaly include:

  • Mononucleosis

  • Hepatitis

  • Cirrhosis

  • Leukemia

  • Lupus

  • Sarcoidosis

An enlarged spleen is also more prone to rupture, a life-threatening condition.

Ruptured Spleen

Trauma, such as a car accident or a significant fall, is a common cause of splenic rupture. This condition results in internal bleeding and requires immediate medical attention. Symptoms may include abdominal pain and referred pain in the left shoulder.

Although rare, ruptures can also occur without trauma, especially in cases of infectious diseases like mononucleosis.

Loss of Function (Asplenia and Hyposplenism)

If the spleen no longer functions properly, the condition is referred to as asplenia. This may result from surgical removal or diseases like sickle cell anemia, autoimmune disorders, or celiac disease. In such cases, the risk of infection increases significantly.

Hyposplenism refers to partial loss of spleen function. Symptoms might be subtle, including fatigue or shivering. Conditions such as chronic liver disease or immune dysfunction can lead to hyposplenism.

Overactive Spleen (Hypersplenism)

In hypersplenism, the spleen destroys blood cells too rapidly. This condition may be linked to cirrhosis, tuberculosis, or lymphoma. Warning signs include an enlarged spleen, frequent fatigue, low blood counts, and early satiety (feeling full quickly).

Diagnostic Approaches

Diagnosing spleen-related issues begins with a physical examination. If an abnormality is suspected, doctors may order imaging tests such as:

  • Ultrasound

  • CT scan

  • MRI

  • PET scan

Blood tests, including a complete blood count, can also assess spleen function. In some cases, biopsies or nuclear imaging (liver-spleen scan) may be necessary.

How to Keep Your Spleen Healthy

To support spleen health, it's essential to maintain a robust immune system and avoid activities that may injure the organ:

  • Avoid smoking and excessive alcohol consumption

  • Get adequate sleep

  • Eat a balanced, nutritious diet

  • Stay physically active

  • Maintain a healthy weight

If you have an enlarged spleen, avoid contact sports or heavy lifting, which could risk rupture. For individuals with reduced spleen function, vaccinations are especially important. Immunizations for pneumococcus, meningococcus, Haemophilus influenzae type b (Hib), and herpes zoster can help prevent severe infections.

Conclusion

The spleen may be small, but it plays an outsized role in maintaining blood health and supporting the immune system. While it's not essential for survival, preserving its function can prevent a host of complications. Understanding its role, recognizing warning signs of dysfunction, and adopting spleen-friendly habits can contribute significantly to your overall well-being. Should problems arise, timely diagnosis and medical care are key to protecting your health.