Causes of Spleen Pain - Causes, Diagnosis, and Treatment

Introduction:

The spleen is present in the left upper part of the abdomen, covered by the ribs. The pain in the spleen can also be due to underlying conditions like cancer, liver diseases, infections, rheumatoid arthritis, and trauma. The symptom can be limited to pain in the spleen but can also spread to the shoulder blade or back. The treatment depends on the underlying disease. A few imaging techniques like X-rays, ultrasound, CT (computed tomography) scans, and MRI (magnetic resonance imaging) help find the condition.

What Is a Spleen and Its Function?

A spleen is a small organ about the size of a fist. It is present in the left upper region. The spleen has two parts, white pulp, and red pulp. The white pulp produces white blood cells. The white blood cells are called the police force of the body and produce antibodies. These antibodies fight against infectious organisms performing an immune function. The red pulp filters the blood and removes old and damaged blood cells. It also destroys infectious organisms like bacteria and viruses. The spleen is also responsible for the fluid balance in the body.

What Causes Pain in the Spleen?

• Rupture or Injury to the Spleen: Injury to the spleen can be due to fights, road traffic accidents, rib cage fractures, and sports activities. Though the spleen is protected and covered by the rib cage, strong and forceful blows injure the spleen. The fractured part of the rib cage penetrates the spleen causing a rupture, leading to hematoma formation. Although the injury to the spleen sometimes does not cause immediate symptoms, delayed symptoms may appear after a few weeks.

• Spleen Enlargement: Spleen enlargement can be due to an injury or an underlying disease condition. The spleen becomes swollen and more prominent in size and presses on nearby structures, creating pain. Some of the diseases that cause splenomegaly are:

1. Leukemia: It is the cancer of the tissues that form the blood. They affect the body’s ability to fight against infections.

2. Lymphoma: Cancer of the cells in the lymphatic system is called lymphoma. The lymphatic system fights against infections and diseases.

3. Systemic Lupus Erythematosus (SLE): Systemic lupus erythematosus is an autoimmune disease where the body's immune system attacks its own healthy tissues and organs. This causes inflammation and damage to the tissues of the affected organ.

4. Gaucher’s Disease: Gaucher’s disease is the abnormal accumulation of fatty substances in the liver and spleen. This causes damage and affects the functions of the organ.

5. Rheumatoid Arthritis: It is an inflammation of the joints resulting from an autoimmune condition. The immune system attacks the tissues in the joint bone areas, causing inflammation.

6. Heart Failure: When the heart does not function normally due to heart muscle weakness or a blockage in the heart or blood vessels.

7. Cirrhosis: Cirrhosis is a liver disease that results from too much alcohol consumption. Scar tissues replace the healthy liver tissues.

8. Sickle Cell Disease: Sickle cell anemia is a blood disease where the red blood cells are damaged and shaped in a sickle form. A sickle is a curved tool used in farming. The red blood cell's half-life is decreased and results in a reduced presence of red blood cells in the blood. This leads to decreased blood flow and results in a chain reaction causing infections and other disorders.

9. Parasite Infection: Malaria is an infectious disease acquired from a parasite-infected mosquito bite, usually the female anopheles mosquito. It is a life-threatening condition that affects other organs.

10. Bacterial Infection: Bacterial infectious diseases like bacterial endocarditis (a bacterial infection that affects the heart's inner layer and heart valves) and miliary tuberculosis (a fatal condition caused by tubercle bacilli that affect the lungs) also affect organs like the liver and spleen.

11. Viral Infection: Viral infections like cytomegalovirus (causes inflammation of multiple organs and causes damage to them) and infectious mononucleosis (caused by Epstein-Barr virus that is mainly transferred from one person to another through saliva (spit) by kissing)

12. Cancer in the Spleen: Abnormal tissue growth in the spleen or cancer from other organs spread to the spleen can cause spleen enlargement.

13. Amyloidosis: Amyloidosis is a rare condition when an uncommon protein called amyloid accumulates in the organs and affects their functions.

14. Hemolytic Anemia: It is a disorder that occurs when the red blood cells are damaged faster than their formation.

• Spleen Infarction: This condition is rare, where the splenic tissues either receive a poor blood supply or there is no blood supply. It can be due to a block by a blood clot in the blood vessels that supply the spleen or liver.

• Drug-Induced: Certain chemotherapy drugs like Oxaliplatin, Fluorouracil, and Bevacizumab cause damage to the spleen. Certain medications like Acetaminophen and estrogen-containing drugs cause harmful effects on the liver and result in portal hypertension (high pressure in the portal veins that supply blood to the liver). Some medications damage the spleen cells directly as a side effect. The effect is resolved once the medicines are stopped.

What Are the Tests to Find the Cause of Spleen Pain?

• Physical Examination: The physician does a physical examination to feel the spleen in the abdominal region. The physician places their hands on the left upper area above the stomach below the ribs to feel the enlarged spleen.

• X-ray: X-ray uses electromagnetic radiation to take pictures of the structures inside the body. It is specifically used to find abnormalities in bony structures.

• Ultrasound Abdomen: Ultrasound is an imaging technique in which images are taken in a high-frequency sound wave. Any abnormality in the spleen will be noted in the ultrasound report.

• CT Scan: Computerized tomography imaging technique gives a detailed view of the organs, bones, muscles, blood vessels, and fat. This technique produces X-ray images with the help of computer technology.

• MRI Scan: Magnetic resonance imaging is used to find diseases or abnormalities in the internal organs and structures. The pictures are generated in a magnetic field and radio wave frequency. It gives a detailed view of the organs and structures surrounding them.

How to Treat the Pain in Spleen?

The treatment depends on the condition or disease that causes pain. The main aim of the treatment will be to reduce the damage to the spleen.

How to Keep the Spleen Healthy?

• Drink plenty of water.

• Exercise regularly.

• Maintain ideal body weight.

• Consume nutritious food by taking equal proportions of proteins, fibers, carbohydrates, and vitamins and minerals.

Conclusion:

Pain in the spleen can be due to many factors like an injury to the organ or an underlying disease that can cause pain. The imaging studies reveal the causes of pain. It will help find the root cause and help in the treatment plan. Certain medications also cause damage to the spleen. There will not be any history of pain in some cases, even with spleen enlargement. When the spleen enlarges beyond its space and presses the neighboring structures, pain occurs. However, visiting a physician as soon as the symptoms develop and getting the treatment done will relieve the patient from pain and reduce the complications.