human spleen

The human anatomy is full of mysteries. One of them is the spleen.

Like all unpaired organs, the spleen, logically, should be carefully “hidden” in the body behind tissues and bones. But in fact, it is very close to the surface and therefore easily injured. The spleen has no unique functions that other organs cannot perform. Yes, and a person can live without it (of course, with a change in lifestyle). But at the same time, the spleen still exists for some reason in all vertebrates. And in China, it is respectfully called – “the second mother of the body.”

What is the spleen for, can it hurt, and how is it treated? We answer these and other questions with candidate of medical sciences, general practitioner of the highest category with a specialization in gastroenterology and cardiology Yulia Esipenko.

What is important to know about the human spleen

Where is the human spleen

The spleen is located in the left upper part of the abdominal cavity, slightly behind the stomach, at the level of 9-11 ribs. That is, if it hurts just above the lower edge of the ribs on the left, this may be the spleen to make itself felt.

Looking at the location of the organs, the spleen is located between the stomach, left kidney and colon.

What does the human spleen look like and how does it work?

Outwardly, the human spleen looks like a flattened bean: an elongated oval shape, purple in color (as it should be for a hematopoietic organ). The spleen belongs to the parenchymal organs: that is, there is no cavity inside (as, for example, in the stomach), and the functional tissue is called the parenchyma. It looks like a sponge, and all physiological processes take place in it.

The “pulp” of the spleen consists of white and red pulp. The first produces B cells, which produce protective antibodies, and T cells, which detect and destroy cells with foreign antigens. Red pulp is needed for blood renewal (destroys old and defective erythrocytes, participates in the processing of iron), and also removes harmful bacteria with the help of macrophages and granulocytes⁴serves as a reservoir for leukocytes and platelets. As a reservoir, the spleen contains about a glass of blood, which is expelled into the general circulatory system when needed.

There are two surfaces of the spleen: diaphragmatic and visceral. On the latter are the gates of the spleen – a kind of port. The splenic artery passes through the gate, from where blood enters the organ, and the splenic vein exits. It collects blood from the spleen, stomach, pancreas, and greater omentum, then joins with the mesenteric veins to form the portal vein. From here, blood with decay products enters the liver for detoxification, in fact, the final processing.

Why can the human spleen hurt

This organ has nerve endings (due to which a person can feel pain) that are in the capsule. Therefore, the spleen can hurt only with an increase in volume, moreover, quite quickly⁵. This can happen for a number of reasons.

Physiological pain may appear, for example, during or after running. Due to the load, the blood volume increases dramatically, the spleen is stretched, and these unpleasant sensations appear in the left hypochondrium, familiar to many (remember at least physical education lessons). In pregnant women, the spleen, along with other abdominal organs, is “oppressed” by the uterus in the later stages, which can also cause pain.

Often the spleen appears in the conclusions of medical experts: the organ is often damaged during fights and violent acts. And although the spleen is located behind the ribs, it is located close to the surface, so it can be injured not only with a weapon, but simply with a fist or even when falling.

There are more pathological reasons for pain in the spleen area. They are manifested not only by pain, but also by other symptoms. Let’s talk about them.

It is generally accepted that a person has only one spleen. But there are abnormal cases of tissue growth: outwardly, it looks like additional “mini-spleens”. They are called in science – accessory spleens.³. The problem is that even despite their small size (usually up to 2 cm), they can compress blood vessels, negatively affecting health.

Displacement of the spleen

Usually the spleen is immobile due to the ligaments holding it. But sometimes, for example, after multiple pregnancies or organ enlargement, the ligamentous apparatus weakens, and the spleen can shift and even twist. Volvulus of the spleen is the most dangerous variant of displacement, because it can lead to thrombosis or even necrosis of the tissues of the organ (necrosis).

A person with a displaced spleen feels pain due to the tension of the ligaments and disruption of the circulatory process.

Thrombosis of the splenic vein

Against the background of pancreatic or infectious diseases, after injuries, such a complication as thrombosis of the splenic vein may develop. But sometimes blood clots in the lumen of the vein form on their own, without previous problems.

With complete blockage of the blood vessel, the outflow of blood from the spleen stops, the organ increases in size.

The peculiarity of the disease is that at first it proceeds unnoticed by a person. Later, there is pain and a feeling of heaviness in the left side, sometimes a high temperature rises. This is how the inflammatory process manifests itself. Sometimes there is a hemorrhagic syndrome: nosebleeds, vomiting with blood.

At the first symptoms, you should consult a doctor: you may need to stop the bleeding in order to avoid complications.

Spleen infarction

This disease is associated with a violation of the blood supply: when for a long time the blood does not flow well into one or another area, it gradually dies off. This happens because the branches of the splenic artery do not connect with each other and cannot help to establish blood flow in the event of a “failure”.

Infarction of the spleen may indicate:

• pain in the left hypochondrium, radiating to the left shoulder (increased by inhalation);
• chills, subfebrile fever⁶.

According to signs, splenic infarction can be confused with acute pancreatitis or pyelonephritis. But in some cases, a heart attack may not manifest itself.

Neoplasms

A cyst is an abnormal cavity in the spleen that can be congenital or acquired (for example, after trauma or parasitic infections). There can be several neoplasms in one organ. Symptoms may not appear for a long time until the cyst (or cysts) increase in size. The pain is moderate. Among other symptoms: heaviness in the left hypochondrium, weakness, urination disorders, stool changes.

If there are no complications, and the cyst itself does not grow rapidly, then usually no treatment is required – but it should be monitored regularly. In difficult cases, various options are possible, up to removal.

Other neoplasms are also distinguished: benign (for example, hemangiomas, lipomas) and malignant.

Fatigue, causeless depression, pain and heaviness in the left side, loss of appetite and sudden weight loss – these symptoms should be paid attention to and immediately consult a doctor.

Abscess

A cavity filled with pus forms inside the spleen. Usually, an abscess develops as a complication of another disease. The cause may be an infection, trauma (when a hematoma begins to fester), or a spleen infarction. In addition to pain, symptoms may include fever, chills, and sweating.

How is the human spleen treated?

For any change in health, you should consult a doctor. For starters, see a therapist. The doctor will examine, prescribe tests and other studies, if necessary, refer to a narrow specialist. Diagnosis may require laboratory tests, ultrasound, fluoroscopy, computed tomography.

After the diagnosis is established, the doctor will prescribe treatment. Conservative therapy, first of all, provides for peace and cold in the region of the left hypochondrium. The rest depends on the disease.

Preparations

The use of medications refers to conservative treatment. Medicines are prescribed only by a doctor and only according to indications.

For example, with a diagnosed abscess, broad-spectrum antibacterial drugs are prescribed in addition to surgical methods of treatment.

Splenopexy

When the spleen is displaced without complications (in the form of scars or necrosis), an operation is performed to attach the organ to the diaphragm. In fact, the spleen is sutured so that it does not move around the abdominal cavity to avoid the risk of twisting.

Resection

The operation is performed if surgery is needed in the upper or lower part of the spleen, and at the same time it is possible to save the organ. Part of the spleen can be removed, for example, with a benign tumor.

Splenectomy

This is the name of the operation to remove the spleen. Indications for this may be various diseases and anomalies (for example, displacement of an organ that provoked volvulus and necrosis).

It is possible to live without a spleen: the main functions of the organ “disassemble” the liver and lymph nodes among themselves. But at the same time, the risk of contracting dangerous infections, such as meningococcus and pneumococcus, increases. Therefore, people who have had their spleen removed for some reason are recommended to be vaccinated against a number of diseases, including influenza.⁴.

Other Treatments for the Spleen

Depending on the indication, different treatments may be required.

Abscesses and some cysts may require percutaneous drainage. Through a small hole, the doctor inserts a drainage tube into the organ, through which the contents of the cavity are removed and treated with an antiseptic solution.

If cancer is diagnosed, the doctor may prescribe chemotherapy and/or radiation therapy. But only in the early stages. Stages 3 and 4 of oncology involve only the removal of the spleen.

How to keep your spleen healthy at home

Prevention of diseases of the spleen includes basic recommendations for maintaining health. This is a balanced diet with a lot of vegetables, herbs and berries, an active lifestyle, the absence of bad habits. But there are some specific rules that you need to follow if you do not want to go to the doctor.

• Reasonable exercise. It is useful to move, because this way you can avoid stagnation in the body. But it is important to follow safety rules – remember that the spleen is vulnerable, it is easy to damage it.
• Clothing according to the weather and size. The spleen can react acutely to hypothermia, but this can be avoided by wearing weather-appropriate outfits in cold and windy weather. At the same time, clothing should be in size, not too tight: belts and belts can interfere with blood circulation.
• Let’s talk about detox. The spleen will feel good if you drink enough pure water every day (namely water, not tea, coffee or juice). It is also important to pay attention to the composition of the foods you eat (different E-Necks should be kept to a minimum). And do not abuse drugs: any “chemistry” negatively affects the state of the spleen and its vessels.

Popular questions and answers

How to recognize the first problems with the spleen, and other popular questions answered candidate of medical sciences, general practitioner of the highest category with a specialization in gastroenterology and cardiology Yuliya Esipenko.

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3. Accessory spleen mimicking a right-sided retroperitoneal tumor. T.A. Britvin, N.A. Korsakova, D.V. Undercut // Bulletin of Surgery. 2017. URL: https://cyberleninka.ru/article/n/dobavochnaya-selezyonka-imitiruyuschaya-pravostoronnyuyu-zabryushinnuyu-opuhol/viewer
4. Overview of the Spleen. Harry S. Jacob  // MSD Manual. URL: https://www.msdmanuals.com/en-gb/professional/hematology-and-oncology/spleen-disorders/overview-of-the-spleen
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6. Surgery for diseases of the spleen. Teaching aid. A.V. Bolshov, V.Ya. Khryshchanovich // BSMU Minsk. 2015. URL: http://rep.bsmu.by/bitstream/handle/BSMU/7986/366534-%D0%B1%D1%80..pdf?sequence=1&isAllowed=y