Dr.(Major) R.S RENGAN M.S., D.N.B., Dip Laproscopic Surgery (University of Strasbourg)

Senior Consultant, General & Laparoscopic surgery                                                                         For Appointment: 94440 42294

Apollo First Med Hospital,Chennai.

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Spleen

The spleen is an organ which lies to the left side of your stomach. It has a shape like a shoe and measures about 4 inches long. In a person whose spleen is healthy it cannot be felt as it is protected by the rib cage.

An important work of the spleen is to remove certain old and deformed cells particularly the aged red blood cells. These red cells are the carriers of oxygen to various part of the body. Once they become old they need to be removed as they can no longer carry oxygen.

Another function is the production of certain cells named the antibodies which acts as the defense system of our body. It also produces other cells which are the part of an important system named the immune system which is the guarding force of our body.

Bacteria and other impure substances in the blood are also destroyed in the spleen tissue. This is done by special cells called the white blood cells particularly the Lymphocytes. When blood passes into the spleen, the lymphocytes react to anything suspicious in the blood and produce antibodies to fight the “invader.”

As mentioned before the spleen is safe and secured by the twelve ribs in the left part of our body. But once when it grows big we always have to suspect a problem.

Many diseases can cause the spleen to grow big and out of our ribs mainly infections and cancer.

Splenic Injury

Our spleen is one delicate organ that is covered by a layer of tissue called the capsule. This capsule entirely covers the spleen except for a small area where the blood vessels enter and exit this organ.

So what causes injuries to the spleen?

  • Accidents on the road
  • Stab with sharp objects/ penetrating injuries where any object enters the body
  • Blunt trauma means a direct blow, such as a punch, or compression against a seat belt or steering column. This force can increase the pressure inside a hollow organ thereby leading to rupture.

These conditions can cause the capsule to tear can lot of bleeding can occur in the inside. This is called as internal bleeding and is one of the major emergency conditions.

The spleen is commonly injured along with the left side ribs, other organs like pancreas, liver and the kidney.

In some diseases the spleen swells up like a balloon and the capsule covering becomes thin. This makes the organ weak and fragile and more likely to rupture if the abdomen receives a direct hit from outside. Malaria is an important cause.

Symptoms

Common symptom after spleen injury is Pain. It depends on how badly the spleen has ruptured and how much of blood is lost.

Pain may be felt in these locations:

  • To the left of your stomach where the spleen is present.
  • Sometimes, pain is felt in left shoulder, because nerves of the left shoulder and in the region around the spleen originate from the same location and the rupture may irritate these nerves.

Blood leaks caused by the ruptured spleen can lead to our blood pressure to drop. This can cause:

  • Disturbances in seeing objects.
  • Fainting.
  • Restlessness, anxiety and the whole body becomes white in color.
  • Heart beats very fast due to fall in BP.

Treatment

Again this depends on the severity of the injury.

Incase injury is not very severe and your other organs are not damaged, your doctor may admit you for a few days in a hospital to keep a close watch.

During this time you may require blood transfusions and your heart rate, pulse temperature maybe checked at regular intervals. These are the vital signs that help to show the state of your body condition.

Bed rest is absolutely essential. Your doctor may prescribe antibiotics to prevent infections that are common in this period.

In case of serious injuries, the spleen has to be removed. But then if there is only a small tear in your spleen it can be closed without actually removing it..

The Spleen In Maleria

The greatest defense in the human body against Malaria is the spleen. The parasites in malaria attack our red blood cells and lives in them. Now these cells while passing through the spleen becomes trapped in that organ and since the infected cells are so much in number, the spleen subsequently becomes very congested, soft and starts to increase in size. This occurs more commonly in non-immune individuals and can lead to spontaneous rupture of the spleen.

The Spleen In Thalssemia

Thalassemia is a disorder is caused by the weakening and destruction of our body’s red blood cells.

Hemoglobin is the protein in red blood cells that carries oxygen. People with thalassemia make less hemoglobin and have very few circulating red blood cells than normal, which results in mild or severe anemia.

Hemoglobin contains Iron which is removed when a red blood cell is destroyed in the spleen. That iron is again re used to make hemoglobin.

When the spleen breaks down a red blood cell in a person with thalassemia, iron often stays inside the spleen rather than being reused. A thalassemic red blood cell often also gets stuck in the spleen because they’re small and have abnormal shape. Both of these factors can cause the spleen to become enlarged.

Another factor is that the red blood cells are produced in a tissue called the marrow which is present in the center of our bones. But in Thalassemic patients more and more red cells are needed to compensate the increased destruction in the spleen. So the spleen will also start to produce red blood cells in addition to destroying them. This makes the spleen grow large in size.

What Happens Later If Your Spleen Is Removed

A person can live a normal life without a spleen. But we know the spleen plays an important role in our body’s ability to fight bacteria and living without the organ puts you at high risk for infections.

Consider the following precautions.

  • So everyone should receive the vaccine for pneumococcus and some should get vaccines for meningococcus and haemophilus influenza type b.
  • Report to your doctor immediately if u have fever, chillness, body ache, sore throat all which indicate infection.
  • If traveling to another country, find out if there are diseases there (such as malaria) which might pose a special threat and for which you would need to be prepared through medications or vaccination.