Spleen enlargement (Splenomegaly)

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By Dr. Lee Ser Yee

The spleen is an organ that sits just below your left rib cage in your abdomen, lying beside the stomach. It is about the size of your fist, and is part of the immune and blood system.

Its functions include filtering out and destroying old, damaged blood cells, preventing infection by producing white blood cells and antibodies, as well as storing red blood cells and platelets, which help your blood clot.

An enlarged spleen can affect each of these functions. When it's enlarged, your spleen may not function as usual.

Many conditions — including infections, liver disease and some cancers — can cause an enlarged spleen. An enlarged spleen is also known as splenomegaly.

Symptoms

An enlarged spleen usually doesn't cause symptoms and may be discovered during a routine physical exam. Sometimes, it can cause the following

Pain or fullness in the left upper belly that can spread to the left shoulder
A feeling of fullness after eating a small amount because the spleen is pressing on your stomach (Early Satiety)
Low red blood cells (anemia)
Frequent infections
Easy Bruising or Bleeding (due to low platelets)

Causes

A number of infections and diseases can cause an enlarged spleen. The enlargement might be temporary, depending on its cause and treatment. These include -

Infections - Viral infections (e.g. mononucleosis), bacterial infections & Parasitic infections (e.g., malaria).
Cirrhosis and other diseases affecting the liver.
Haemolytic anemia — a condition characterized by early/excessive destruction of red blood cells
Blood Cancers - such as leukaemia and myeloproliferative neoplasms, lymphomas e.g. Hodgkin's disease,
Cancers of the spleen - Lymphoma, Angiosarcoma, metastases.
Benign tumors – e.g. Haemangioma, Lymphangioma, Hamartoma, Inflammatory pseudotumor, Splenic cyst.
Metabolic disorders, such as Gaucher disease and Niemann-Pick disease.
Autoimmune conditions, such as lupus or sarcoidosis.

Treatment

Imaging and blood tests can help identify the cause of an enlarged spleen. Depending on the cause of the splenomegaly, removal of the spleen (splenectomy) may be required for diagnosis, symptomatic relief and definitive treatment.

This can be performed via keyhole techniques (minimally invasive surgery) to minimise pain, scars and hasten recovery.

To find out more, please consult a spleen surgeon.

Splenomegaly Singapore

Dr Lee Ser Yee

Senior Consultant Hepatopancreatobiliary Surgeon

MBBS, MMed (Surgery), MSc, FAMS, FRCSEd

Prior to private practice, liver surgeon Dr Lee Ser Yee was a founding member and Senior Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at Singapore General Hospital (SGH). He served as the Director of the Laparoscopic programme and the Director of the Surgical Skills Training Program and the SingHealth Surgical Skills Centre.

He started his medical training at the National University of Singapore in 1996 and completed his training in General Surgery, HPB surgery and Liver Transplantation at SGH and National Cancer Centre, Singapore.

He also completed dual USA-fellowships in Advanced Laparoscopic HPB surgery and Liver Transplantation under Professor Daniel Cherqui at the New York Presbyterian Hospital-Weill Cornell Medical Center and a Complex Surgical Oncology clinical fellowship at Memorial Sloan Kettering Cancer Center in New York.

Mount Elizabeth Medical Centre
#08-07, 3 Mount Elizabeth, Singapore 228510
Tel: 6454 0054 | Fax: 6764 0054 | Email: ask@surgicalassociates.sg

Gleneagles Medical Centre
#05-01, 6 Napier Road, Singapore 258499
Tel: 6471 0054 | Fax: 6271 0054

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