Published: 18 Jun 2025

ICD9: 789.2      ICD10: R16.1      ICD11: ME10.01

Splenomegaly refers to the enlargement of the spleen.
The spleen is an organ located in the upper left abdomen, under the rib cage. It plays a vital role in filtering blood, removing old and damaged blood cells, storing white blood cells and platelets, and fighting infection.

When the spleen becomes enlarged, it can indicate an underlying medical condition. It's not a disease in itself, but rather a symptom of another problem.

Causes of Splenomegaly:

Splenomegaly can be caused by a wide range of conditions, including:

Infections:
Viral: Infectious mononucleosis (Mono), Cytomegalovirus (CMV), Hepatitis
Bacterial: Endocarditis, Tuberculosis, Brucellosis
Parasitic: Malaria, Leishmaniasis
Liver diseases:
Cirrhosis
Portal hypertension
Blood disorders:
Hemolytic anemias (e.g., sickle cell anemia, hereditary spherocytosis)
Thalassemia
Leukemia
Lymphoma
Myeloproliferative disorders (e.g., polycythemia vera, essential thrombocythemia)
Inflammatory conditions:
Sarcoidosis
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis
Infiltrative diseases:
Gaucher disease
Niemann-Pick disease
Amyloidosis
Cysts and tumors:
Splenic cysts
Primary splenic tumors
Metastatic tumors
Congestive splenomegaly:
Heart failure
Portal vein thrombosis
Splenic vein thrombosis

Symptoms of Splenomegaly:

Many people with an enlarged spleen may not experience any symptoms. However, when symptoms do occur, they can include:

Fullness or pain in the upper left abdomen: This is the most common symptom. The pain may radiate to the left shoulder.
Feeling full after eating only a small amount: The enlarged spleen can press on the stomach.
Fatigue: This can be caused by anemia or the underlying condition causing the splenomegaly.
Frequent infections: The spleen's filtering function may be impaired.
Easy bleeding: The enlarged spleen may trap platelets, leading to thrombocytopenia (low platelet count).
Anemia: Due to increased destruction of red blood cells by the spleen.

Diagnosis:

Splenomegaly is often discovered during a physical examination when a doctor palpates (feels) the abdomen. Other diagnostic tests include:

Blood tests: Complete blood count (CBC), liver function tests, and tests to check for infections.
Imaging tests:
Ultrasound: A non-invasive way to visualize the spleen.
CT scan: Provides a more detailed image of the spleen and surrounding organs.
MRI: Can be used to further evaluate the spleen.
Bone marrow biopsy: May be necessary to evaluate blood disorders.

Treatment:

Treatment for splenomegaly depends on the underlying cause. Options may include:

Treating the underlying condition: Addressing the cause of the splenomegaly is the primary goal. For example, antibiotics for infections, medication for blood disorders, or surgery for certain tumors.
Splenectomy (surgical removal of the spleen): This is usually a last resort and is considered when the enlarged spleen causes severe complications or when the underlying cause cannot be treated effectively. Following a splenectomy, patients need to be vaccinated against certain infections because the spleen's filtering function is lost.
Watchful waiting: In some cases, if the splenomegaly is mild and not causing symptoms, the doctor may recommend monitoring the condition without immediate treatment.

Importance of Seeking Medical Attention:

If you suspect you have splenomegaly, it is important to see a doctor for diagnosis and treatment. Identifying and treating the underlying cause is crucial for preventing complications. Self-treating is not advised.