Even though most people don’t know that much about the spleen, it remains an important abdominal organ that performs many functions. Located behind the stomach in the upper left side of the abdomen, the spleen is a fist-sized organ that is part of the lymphatic system, which itself is part of the immune system. The spleen’s most basic role is to act as a filter for our blood to remove old blood cells and detect pathogens that may have entered the body.

Structure of the Spleen

The spleen is situated in the upper left quadrant of the abdominal cavity below the diaphragm and behind the rib cage; it sits between the stomach, kidney, and pancreas. The spleen is surrounded by a capsule of connective tissue that is held in place by various ligaments. Because of its main role as a blood filter, the spleen is also highly vascularized with its blood supply coming from the splenic artery. It is also a relatively small organ, typically measuring 3 to 5 inches in length for most adults.

Unlike many other organs, the spleen doesn’t really have easily distinguishable regions or sections. Instead, it is composed of two different types of tissue that are intermingled throughout: red pulp and white pulp. White pulp is lymphoid tissue that surrounds the many splenic blood vessels and contains plasma cells, lymphocytes, and lymphatic nodules. Red pulp consists of a network of splenic cords and sinusoids and primarily serves as a reservoir for a type of white blood cells called monocytes.

Function of the Spleen

As noted, the spleen has multiple functions depending on the type of tissue involved. White pulp, which accounts for 25% of tissue in the spleen, is primarily involved with the normal immune response to a potential infection. When a pathogen is detected, lymphocytes stored in the spleen are activated and produce antibodies. These antibodies are then dispersed through the lymphatic system to seek out and attack the pathogen. White pulp in the spleen is the body’s main source of antibodies.

The other 75% of splenic tissue is red pulp, and it is mostly involved in filtering blood in a similar way that the lymph nodes filter lymph fluid. One of the main functions is to remove old and damaged red blood cells from circulation so that new healthy blood cells can take their place. In addition to filtering the blood for old blood cells and some forms of bacteria, the spleen also acts as a reservoir for platelets and red blood cells that can be released into the bloodstream in the event of an injury that results in blood loss.

Potential Spleen Problems

Technically the spleen isn’t considered a “vital” organ since a person can still live a relatively normal life after it has been removed. But because of its role in regular immune function, no longer having a spleen can increase the risk of infection and disease. Fortunately, though, it’s fairly rare to need one’s spleen removed, though there are a number of potential problems that can affect the organ:

  • Enlarged spleen: One of the most common problems that can affect the spleen is when it becomes enlarged. Technically known as splenomegaly, an enlarged spleen is almost always the result of an underlying condition rather than being a primary disease. Potential causes include bacterial infections, viral infections (especially mononucleosis), liver disease, cirrhosis, leukemia, or lymphoma.
  • Ruptured spleen: Another potential cause of spleen problems is physical trauma. Even though the location of the spleen makes it somewhat protected by the rib cage, a chest injury from something like a car accident could cause the organ to rupture. A rupture or tear in the spleen often leads to internal bleeding and is considered a life-threatening emergency. While rarer, a ruptured spleen can sometimes occur from non-traumatic causes after swelling has lead pressure to build up for a while.
  • Asplenia: Functional asplenia is a condition that is characterized by the spleen not functioning properly. In many cases asplenia means the spleen is overworking (hypersplenism) and destroying healthy blood cells along with old and damaged ones. Asplenia is usually accompanied by an increased risk for infection and bruising. The most common causes of asplenia are physical trauma, sickle cell disease, and celiac disease.
  • Anemia: Sickle cell anemia is the most common type of a group of blood disorders called sickle cell disease. Sickle cell anemia is an inherited condition that involves an abnormality in the hemoglobin of red blood cells that tends to affect blood flow throughout the body. This disease can cause damage to the spleen as well as reduced immune system function that can increase the risk of other illnesses.

Treatment Options for the Spleen

Given how many different possible problems there are that can negatively affect the spleen, it’s perhaps surprising that the treatment options are relatively limited. For the most part, any spleen problem will be resolved by treating the underlying condition. For instance, a case of sickle cell anemia can be managed with medication, lifestyle changes, or in rare situations a bone marrow transplant. For cases of infection or asplenia, antibiotics or vaccines are typically used.

For essentially any spleen problem that can’t be treated by medication and therapeutic measures, the standard approach is surgery. Spleen removal (splenectomy) surgery is commonly performed using laparoscopy in order to limit normal surgical complications and risks. Depending on the nature of the problem, either part or all of the spleen is removed during the surgery. With some lifestyle modifications, most people can go on to live normal lives after the surgery.

Living Without a Spleen

Because of the spleen’s importance in blood filtration and immune function, living without one does require some adjustments. Fortunately other organs like the liver can take over some of these functions, but the patient will still be more susceptible to certain kinds of infection like pneumonia or meningitis. The biggest downside is that this increased risk will remain for the remainder of a person’s life.

In order to mitigate the increased risk of infection, most splenectomy patients will have to take regular low doses of antibiotics, especially during the first two years after the operation. People who have had their spleen removed also need to make sure they are updated with all vaccinations. They also need to be especially vigilant in being on the lookout for signs of infection like fever and coughing.

Request an Appointment with Cary Gastro

The spleen is an important organ of the lymphatic system, but there are some ways that its function can interact with the digestive system. While there aren’t a lot of obvious symptoms related to spleen problems, it’s always best to be aware of changes to your body. If you have been experiencing any unusual symptoms and are unsure what they might mean, it is best to get advice from experts like the highly qualified staff at Cary Gastro. Please contact us today to request an appointment.