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Spleen pain - causes and treatment

Spleen pain - causes and treatment


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Spleen pain can have different causes. These include, for example, enlargements of the organ, which can be noticed in both an over- and a under-function. In addition, the spleen can tear due to external influences. The structure and function of the organ and the most common underlying diseases that trigger spleen pain are described below.

The spleen

The spleen is a bean-shaped organ that lies under the left costal arch and borders on the diaphragm (diaphragm), stomach and left kidney. Because of its proximity to the diaphragm, it moves with the breath. The average size of the spleen is 4x7x11 centimeters, with the size and weight strongly depending on the blood volume and the condition of the organ. Their weight is usually between 150 and 200 grams. The spleen belongs to the human lymphatic system, which most medical laypersons are familiar with especially in connection with swelling of the lymph nodes.

As the spleen is made of a very soft tissue (pulp), it is surrounded by a capsule for protection, which gives it stability. The spleen is not a vital organ. If she is injured in an accident, for example, she often has to be removed due to heavy bleeding. Then other organs such as the liver take over. Affected people often suffer from a greater susceptibility to infection.

Functions of the spleen

The spleen has two essential functions in the body: first, it acts as a filter in the bloodstream, second, it is part of the immune system and plays an important role in the immune system. The two functional units can be recognized by the different colors. The filter unit is well supplied with blood and red (red pulp). The area responsible for immune defense is white (white pulp).

In the red pulp of the spleen, older red blood cells (erythrocytes), which are approximately 120 days old, are filtered out of the bloodstream and broken down. Young fresh red blood cells, on the other hand, slip through the close-meshed tissue of the spleen and are still available to the bloodstream. A large artery (artery) delivers the blood for this purpose and it drains off again through a vein.

The function of the white pulp relates to the body's immune system. White blood cells (leukocytes) are collected here, as in some other places in the body. The leukocytes that are important for the immune system are the so-called lymphocytes. They ward off pathogens floating by in the white pulp of the spleen or are washed back into the bloodstream after some time in order to also react there to unwanted intruders.

Splenic enlargement as the cause

Splenomegaly is the acute or chronically enlarged spleen. This is not a disease of its own, but a medical finding that can indicate various causes. As a rule, the causative disease does not only refer to the spleen.

Blood disorders such as leukemia or Hodgkin's disease are common,
a malignant tumor of the lymphatic system. Infectious diseases can also trigger splenic enlargement. These include, for example, Pfeiffer’s glandular fever or sepsis caused by bacteria in the blood.

Rheumatic diseases such as systemic lupus erythematosus can trigger an enlargement of the spleen. Since it is an autoimmune disease, the body's own tissue is attacked by the immune system instead of harmful bacteria and viruses. This creates numerous antibodies that stick together and deposit in different places in the body. This process can also cause damage to organs such as the spleen.

Another cause of splenic pain due to splenomegaly can be blood build-up in front of the liver. Here the blood builds up back to the spleen, since it cannot drain from the gastrointestinal tract through the liver. Among other things, this is the case with cirrhosis of the liver, hepatitis (inflammation of the liver) or with inflammation of the pancreas (pancreatitis). Tumors can also lead to an enlargement of the spleen.

If the spleen reacts to splenomegaly with an overactive condition (hypersplenia syndrome), the organ stores too many red and white blood cells and platelets and at the same time breaks down too many, which leads to anemia.

If the spleen is enlarged, this can lead to pain in the area of ​​the organ. Since, as described, other underlying diseases are usually the trigger for splenomegaly, corresponding symptoms also occur, which include, for example, fever in the case of infections or cancer and joint pain in the case of basic rheumatic diseases. If the pain originates from the spleen itself, it can spread to the left shoulder.

Spleen pain from sickle cell anemia

Sickle cell anemia is a genetic disease in which the structure of hemoglobin (red blood pigment) has changed. As a result, the red blood cells have a different structure and no longer resemble the appearance of a round inflatable boat, but appear crescent-shaped. Since the blood cells formed in this way are less flexible, they can block small vessels, such as those in the spleen, and thus obstruct the vital blood supply to the organs. The spleen also increasingly filters these red blood cells from the blood and breaks them down.

Thalassemia as a cause of spleen pain

Another possible cause of spleen pain is thalassemia. This is an inherited disease, which affects the formation of hemoglobin in different ways. The red blood pigment normally binds the oxygen to transport it. In thalassemia, the blood pigment is changed and can no longer bind the oxygen sufficiently.

The result is a reduced supply of oxygen in various tissues. The most well-known complaints when the clinical picture is present are the typical signs of anemia such as chronic fatigue, dizziness, headache, palpitations and generally pale skin or pale face. Those affected often suffer from exhaustion and exhaustion, are quickly out of breath and can often find it difficult to concentrate,

Spleen infarction

In a splenic infarction, those affected experience severe abdominal pain in the left upper abdomen. The term “infarction” basically describes the loss of tissue due to a lack of oxygen. The cause is a current circulatory disorder.

In most cases, patients have previously suffered from other diseases such as leukemia, blood poisoning, endocarditis or atrial fibrillation. If the occlusion is not complete, the splenic infarction can also be “silent”, i.e. without symptoms. An infarction on the spleen must be treated immediately by emergency medicine.

Splenic tear as a cause of spleen pain

The spleen is well protected due to its location under the left costal arch. The spleen can only tear if there are massive external influences, such as a serious accident or a blow to the corresponding area. If the ribs break, the sharp edges of the ribs can injure the organ.

If a splenic tear occurs, this is associated with very heavy bleeding, so that often only the removal of the spleen is an option. In the case of minor injuries, a special adhesive can be used to “patch” the organ in some cases.

Symptoms of a splenic tear (splenic rupture) include a lack of blood in the circulation due to the heavy bleeding into the abdomen. The abdominal wall muscles become very hard with strong, rapid bleeding. If the bleeding is slow, the patient may not experience any symptoms at first.

However, if the blood loss becomes so great that there is a sharp drop in blood pressure in the blood vessels, symptoms of poor blood circulation appear. The brain is particularly vulnerable. It reacts with dizziness, confusion, sudden vision problems, or headache. Both rapid and slow bleeding from the spleen into the abdomen is life-threatening for those affected and requires immediate medical emergency measures.

Removal of the spleen

In an acute case, doctors with an injured spleen often have no other option due to the heavy bleeding to remove it surgically (splenectomy). The organ has no vital function, but splenectomy does involve certain risks. First and foremost, the long-term defense against infections is part of this, as an organ of the immune system is missing due to the removal of the spleen.

Certain bacteria (e.g. pneumococci and meningococci) can become particularly dangerous for patients by causing diseases such as pneumonia or meningitis, inflammation of the ears or sinus infection. Therefore, affected people are advised to be vaccinated against these pathogens two to three weeks before the spleen is removed. The vaccination should be repeated every five to ten years.

Children should not have their spleens removed before the age of six (if possible) because their immune systems are significantly weaker than those of adults. The course of the disease caused by the bacteria described is therefore usually more serious and more dangerous.

Applications of naturopathy

In naturopathy there are some approaches to relieve pain in the spleen. Hildegard von Bingen wrote: The fir cream consisting of fir tree top extract, bark extract, may butter and sage can be rubbed onto the affected area to reduce the pain.

However, symptom relief does not cure the underlying disease. For this reason, in-depth diagnostics with a specialist internal medicine specialist are essential. Affected people should consult a doctor if they have symptoms and coordinate the therapy together. However, the pine ointment can certainly be used to support medical care. (sw, nr)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese, Barbara Schindewolf-Lensch

Swell:

  • Carol S. Portlock: Hodgkin's Lymphoma (Hodgkin's Disease), MSD Manual, (accessed September 9, 2019), MSD
  • German professional association of ear, nose and throat specialists: Pfeiffer's glandular fever - signs and course, (accessed 09.09.2019), no
  • Robert Koch Institute (RKI): sepsis (access: 09.09.2019), rki
  • German Society for Digestive and Metabolic Diseases (DGVS): S3 guideline on chronic pancreatitis: definition, etiology, diagnostics and conservative, interventional endoscopic and operative therapy of chronic pancreatitis. As of August 2012 (under review). AWMF Register No. 021/003, (accessed September 9, 2019), AWMF
  • Harry S. Jacob: Enlarged Spleen, MSD Manual, (accessed September 9, 2019), MSD
  • Evan M. Braunstein: Thalassemia, MSD Manual, (accessed 09.09.2019), MSD
  • Thomas S. Müller, Christoph Sommer: The traumatic splenic rupture, Therapeutische Umschau (2013), 70, pp. 177-184. (Accessed 09.09.2019), doi


Video: Swollen Spleen - Causes, Symptoms, Dangers (June 2022).


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