What You Need To Know About Your Spleen
Medically reviewed by Isabel Casimiro, MD, PhD
The spleen is a small organ inside your left rib cage, located just above the stomach. It contains numerous blood vessels that are responsible for filtering your blood as well as carrying and circulating fluids in your body. Your spleen also helps fight off infections.
Although your spleen performs several important roles within your body, it is an organ you can live without if it needs to be removed for some reason.
The spleen can be affected by many diseases. When this happens, the organ may become enlarged or stop functioning. And if your spleen undergoes trauma, like from a serious car accident, it can rupture, causing life-threatening internal bleeding.
Here is what you should know about your spleen, including what it does and how to keep it healthy.
Illustration by Dennis Madamba for Health
Anatomy of the Spleen
Your spleen is a small organ the size of a closed fist—about 4-5 inches big. It weighs 5-7 ounces and appears reddish purple because it contains numerous blood vessels.
The spleen is located in your upper-left abdomen. It's inside your left rib cage, between the ninth and 11th ribs. It's positioned between the fundus of the stomach (the upper-curved portion of the stomach) and diaphragm. The top of the left lobe of the liver, the left kidney, and the tail end of the pancreas are all in that same area.
The spleen is divided into many smaller internal sections called lobules. The outside has two sides that are quite different. One side curves out and is smooth; the other side curves inward and is irregularly shaped due to the left kidney, colon, and pancreas butting against it.
The spongy organ has a weak outer connective tissue that covers and protects it. The tissue also allows for the spleen to expand.
Anatomical Variations
Some variations to the spleen are more common than others. For instance, it is not uncommon for the spleen to differ in shape—known as lobulation of the spleen—such as by having deeper clefts and notches than usual. Accessory spleen is a variation that is also more common and is when there is splenic tissue outside of the spleen.
On rare occasions, someone might be born with no spleen. It's also possible to be born with multiple spleens. The additional spleens are the same size, and there could be more than a dozen of them. This condition is known as polysplenia.
Some people have what's called a wandering spleen, which is when the organ moves to the lower abdomen or even into the pelvic cavity. This could be because of abnormalities of the structure or elasticity of the ligaments that are supposed to keep the spleen in place.
What Does the Spleen Do?
Your spleen is a busy organ that primarily stores and filters blood. It removes cellular waste and gets rid of old or damaged blood cells. The spleen also makes white blood cells and antibodies that help you fight infection. The organ even helps maintain the fluid levels in your body.
The spleen's two tissue types—red pulp and white pulp—are responsible for separate things.
The red pulp, which consists of wide blood vessels and cords or threads of connective tissue, filters your blood and removes old, damaged, or useless red blood cells. The red pulp also destroys microorganisms such as viruses, bacteria, and fungi and houses white blood cells and platelets. These white blood cells and platelets are usually released to help with your healing or to assist when you are losing blood.
Meanwhile, the white pulp produces white blood cells and helps them mature. The white pulp also helps produce antibodies.
While the spleen is the largest organ of your lymphatic system—the system that's part of your immune system and helps with immune function—it is possible to live without your spleen. That is good news for people who have to have it removed for medical purposes or are born without one.
Associated Conditions
Your spleen can be affected by a number of diseases and conditions that can cause it to become enlarged or stop functioning properly. It can even become damaged or rupture, causing life-threatening internal bleeding.
Typically, healthcare providers will treat the underlying condition that is causing the problems with your spleen. And if absolutely necessary, your spleen can be removed with a spleen removal surgery called a splenectomy. When this occurs, other organs in your body will take over the role of the spleen. However, you will be more vulnerable to infections. Some healthcare providers feel that, if possible, the spleen should not be removed.
Here is a closer look at some of the conditions that can impact your spleen:
Enlarged Spleen (Splenomegaly)
There are several conditions that can cause your spleen to swell or get larger than it should. Not only does an enlarged spleen cause pain and an uncomfortable feeling of fullness, but it also is a dangerous situation. When your spleen is enlarged, it is more prone to rupturing (which is when it tears open) or bleeding.
Conditions that can potentially lead to splenomegaly include the following:
Infections like mononucleosis (mono), syphilis, malaria, and inflammation of the heart valve (endocarditis)
Blood cancers, including leukemia and Hodgkin's lymphoma
The entrapment of too many red blood cells in the spleen, an event known as splenic sequestration that's associated with pediatric sickle cell and thalassemias
Inflammatory conditions such as sarcoidosis
Connective tissue diseases, including systemic lupus, rheumatoid arthritis, and Still's disease
Venous thrombosis or blood clots
Anemia, including hemolytic anemia
Ruptured Spleen
Splenic rupture is when your spleen tears open. The rupture is usually the result of trauma such as a fall, blow to the abdomen, or car accident. In fact, 50%-75% of traumatic injuries to the spleen are the result of a car accident.
If your spleen ruptures due to trauma, it can happen immediately or be delayed.
While rare, the spleen can also rupture due to non-traumatic causes. Non-traumatic splenic ruptures occur in only 0.1% of people. An infection with mono is one reason a spleen might rupture.
Symptoms of a ruptured spleen include abdominal pain, tenderness, or discomfort, as well as sharp pain that radiates to the left shoulder.
Loss of Function
When you lose complete function of your spleen, it is known as asplenia. When a condition causes you to lose complete function of your spleen, it is known as functional asplenia. Most commonly, it is sickle cell disease that causes functional asplenia.
The following condition may also cause you to lose total function of your spleen:
Inflammatory bowel disease
Beta thalassemia
Advanced HIV infection
A high platelet count (thrombocytosis), a high white blood cell count (lymphocytosis), and a high number of infection-fighting white blood cells called monocytes (monocytosis) are potential signs of functional asplenia.
It's also possible to experience partial loss of function of your spleen. This is known as hyposplenism. Conditions that can damage your spleen, like sickle cell disease, immune disorders, and chronic liver disease, can cause hyposplenism. Symptoms can include fatigue, malaise, and shivering.
Overactive Spleen
Sometimes a spleen can be too active. This is known as hypersplenism. When a spleen is overactive, it removes blood cells to early and too quickly. This may be caused by cirrhosis (permanent scarring of the liver), tuberculosis, and cancer in the lymph system (lymphoma).
Signs that your spleen is overactive include:
An enlarged spleen
Blood tests that show low levels of one or more types of blood cells
Feeling full too soon after eating
Left-side stomach pain
Diagnostic Testing
If your healthcare provider suspects an issue with your spleen or they want to see how your spleen is faring if you have a condition that affects it, they will likely perform a physical exam first. By massaging your abdominal area, they can usually tell if the organ is enlarged. There also are a number of tests that can be used to diagnose issues with the spleen.
For instance, imaging tests such as an abdominal X-ray, ultrasound, or computed tomography (CT) scan may be used to diagnose splenomegaly. In addition to spleen enlargement, imaging can identify other issues like a splenic abscess, lesions, vascular abnormalities, cysts, inflammatory changes, and traumatic injury. Additionally, magnetic resonance imaging (MRI), positron emission tomography (PET) scans, liver-spleen colloid scanning, and splenic biopsy may also be used.
Blood tests like a complete blood count and liver function tests can be used to determine how well your spleen is functioning. Your healthcare provider also may order rheumatological panels and disease-specific infectious testing.
Tips for Keeping Your Spleen Healthy
Because the spleen is part of the lymphatic system and plays a major role in keeping your immune system functioning and healthy, most of the things you do to boost your immune system will also have a positive impact on your spleen.
This can include stopping smoking, avoiding excessive alcohol use, and getting enough sleep. Eating a well-balanced diet, being physically active, and maintaining your optimal weight also are important to healthy immune function.
If you have an enlarged spleen, such as from an infection like mono or a blood cancer like leukemia, it is a good idea not to engage in contact sports, heavy lifting, or other activities that could put you at risk of rupturing your spleen.
If your spleen does not function properly, it's a good idea to keep up-to-date on your vaccines to reduce the risk of life-threatening infections that your spleen is less able to help with. This includes the vaccines for pneumococcal disease, meningococcal disease, Haemophilus influenzae type b (Hib) vaccines, and herpes zoster.
A Quick Review
Your spleen, which is located in the upper-left side of your abdomen, plays an important role to your health. Not only does it filter your blood, but it also helps fight infection and maintain the fluid levels in your body.
Certain conditions can impact the health of your spleen and its ability to function. For instance, some infections and diseases, like mono and anemia, can cause the spleen to become enlarged. This can put the spleen at greater risk for rupturing. The spleen may even stop functioning if you have a long-term disease or illness like celiac disease or certain autoimmune conditions. While the spleen plays a role in keeping you healthy, it can be removed if need be.
If you have a condition that may affect the health of your spleen or your healthcare provider suspects there may be an issue with the organ, there are multiple imaging and blood tests that can assess the health of the organ.
To keep your spleen healthy, it is important to take steps to boost your immune system. And if it becomes enlarged, you should refrain from participating in any activities that could cause it to rupture since that can cause life-threatening internal bleeding.
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