Chủ Nhật, 13 tháng 10, 2013

Spleen

Spleen

What is Spleen?


The spleen is another important organ of the body which is primarily responsible for the storage of blood (especially in case of hemorrhage) and the trapping of pathogenic microorganisms. Every vertebrate has a spleen which normally assumes a brownish color and weighs around 0.44 pounds in healthy adults. It is normal for the spleen to enlarge following digestion. However, certain conditions may also cause enlargement of the spleen or splenomegaly. These include malaria and mononucleosis infection. You will know everything there is to know about this organ in the following snippets.








Spleen Function


It would be nearly impossible for us to go through life without the spleen. It is ever hard to imagine not having to go through certain infectious process because the primary function of the spleen has something to do with the regulation of the immune system. Generally, the spleen has two functions which are dependent on the type of pulp; either it’s the white one or the red one. The white pulp of the spleen is primarily responsible for eliciting an immune response via the cell-mediated or humoral immunity. On the other hand, the red pulp portion of the spleen does the filtration of the red blood cells. The spleen also has several other functions which include the following:



  • Aside from filtering the red blood cells and initiating an immune response, the spleen also produces certain substances in the form of tuftsin, opsonins and properdin, which are responsible for binding with antigens.

  • The spleen is also considered to be a hematopoietic organ which is capable of producing certain blood cells. During the gestation period, the spleen produces red blood cells to the developing fetus up until the fifth month. Soon as the fetus is born, the spleen does not anymore produce red blood cells. Instead, the bone marrow does all the red blood cell production. This is especially true in adults. Nevertheless, even after birth the spleen can still be considered a hematopoietic organ because this never halts producing lymphocytes and thus tagged as the center of the reticuloendothelial system.

  • Formed elements and blood components specifically, can also be stored in the spleen. The primary blood cells that are being stored in the spleen include red blood cells and lymphocytes. In emergency cases, the spleen is also able to release platelet and about one-fourth of the lymphocytes are also being stored by the spleen at a single time.

  • In a study conducted on mice, it was also found out that the spleen is also able to store monocytes that when there’s an injury to tissues these monocytes would be transformed into macrophages and dendritic cells which will later on help facilitate tissue repair.


Spleen Location


The spleen is located towards the left of the diaphragm or to the upper left aspect of the abdomen. It typically appears to be somewhat mottled by purple and grey tones. This occupies the space between the 9th and 12th rib and is about 11 centimeters in length. It would be pretty facile to get acquainted with the spleen by simply recalling the 1x3x5x7x9x11 rule which would mean that the spleen’s dimension is 1x3x5 inches and approximately weighs about 7 ounces, lying behind the 9th and 11th thoracic rib. Isn’t this pretty nifty to memorize? This is also considered to be part of the lymphatic system and is only composed of efferent lymphatic vessels, same with the thymus. The spleen gets its blood supply directly from the splenic artery and short gastric arteries.


Spleen Pain


Knowing the anatomical location of the spleen is highly critical because this would help tell you that the pain you’re experience right through your abdomen is coming from the spleen itself. Again, you should well acquaint yourself that the spleen is situated at the upper leftmost portion of your abdomen. When you can feel pain over this area, it is likely that you are suffering from splenic pain.


Symptoms
Aside from the manifestation of pain itself, there may also be other symptoms involved. Nonetheless, these symptoms may not be entirely noticeable unless the spleen has become large enough to cause symptoms such as:



  • Deep breathing triggers severe pain

  • Feeling of fullness even with small meals

  • Dull pain which may be localized over the upper back or the mid-back

  • Easy fatigability and weakness

  • Sudden and unexplained weight loss

  • Feeling of restlessness

  • Vulnerability to infections


Causes
Just like the other organs of the body, the spleen is also as fragile specifically since it is spongy and soft which makes it even more vulnerable to injury. As your spleen begins to enlarge this would begin to trigger a painful sensation alongside. Aside from splenomegaly, there can also be other causes of pain on the spleen and these may include the following:



  • Pain may manifest with an enlarged spleen because this creates pressure on the lymphatic vessels. Blockage due to the presence of clots, specifically clumping platelets, may also trigger the pain.

  • This may also be due to infections like mononucleosis caused by the Epstein-Barr virus. Infectious mononucleosis, however, is more common in adults and even in adolescents. Children are seldom affected.

  • Getting infected with the causative agents of syphilis and endocarditis would also likely cause a painful sensation over the spleen.

  • Pain over the spleen may also be elicited by parasitic infections such as malaria and toxoplasmosis.

  • Rapid destruction of premature red blood cells

  • Leukemia

  • Hodgkin’s lymphoma

  • Presence of metabolic disorders like Niemann-Pick disease and Gaucher’s disease

  • Suffering from a condition called amyloidosis where there’s protein deposition in certain areas of the body.

  • Direct injury to the organ such that of in vehicular accidents

  • Presence of cysts or abscesses close to the spleen

  • Suffering from an inflammatory disease like rheumatoid arthritis


Treatment
Early detection of problems which concern the spleen is highly critical because when these are just being left untreated, these may probably lead to life-threatening situations. The treatment for pain relating to the spleen would vary immensely depending on the underlying pathology. Before your physician would prescribe you a specific treatment, your exact condition must first be determined. For instance, when the splenic pain is primarily felt due to an underlying infection may entirely be treated with antibiotics. When for instance this is caused by the presence of tumor near the spleen, surgery, chemotherapy and other common ways of treating cancer may help palliate or perhaps treat the condition. However, when it is all due to a ruptured spleen, a splenectomy, which is the surgical removal of the spleen, may be indicated. This surgical procedure poses several risks though. Since the spleen has been already removed, the person this time becomes more susceptible to infections. Thus, vaccines and antibiotics may be prescribed as a form of prophylactic management.

Spleen Problems


The spleen is a highly sensitive organ and even a slight injury to it would mean a serious thing. There can be several problems that may affect the spleen. However, the most common one is believed to be spleen enlargement and some conditions may have brought about this.



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Enlargement of the Spleen- Splenomegaly


Spleen enlargement or splenomegaly is unhealthy. Though there are some bodily processes (i.e. digestion) that would normally cause the spleen to increase in size, it is but abnormal to find an enlarged spleen. There are numerous sited reasons for splenomegaly. Some of them include getting affected with infectious mononucleosis, leukemia, lymphoma, polycythemia vera, liver cirrhosis and many others. All of the previously mentioned conditions would likely lead to spleen enlargement. Another major aggressor to the spleen is a condition called sickle cell anemia wherein the cells would form like sickles causing them to die prematurely. These premature sickle RBCs get amassed into the spleen thereby altering its functions. Splenomegaly is thought to be a serious problem because this would cause the organ to function improperly.


The spleen gets inflamed in the presence of an infectious process because this would be stimulated to trap more RBCs, platelets and other blood cells than the normal rate. The more blood cells and other foreign bodies get trapped therein would further cause the spleen to enlarge to the point of getting ruptured which is massively a medical emergency. The enlargement of the spleen due to excessive trappings of blood cells and other components is otherwise known as hypersplenism. When the spleen has reached its full size and its own blood supply cannot anymore suffice, this would eventually lead to its own death.


Hyposplenism


This is another problem which involves the spleen. In a condition called hyposplenism, the spleen eventually loses its normal functions leading to some serious problems, specifically increased susceptibility to infection. The decreased function of the spleen would inversely cause the peripheral elements to increase in number.


Asplenia


Compared to hyposplenia, asplenia is much a serious concern because in this condition, the spleen ceases to function entirely which even more predisposes an individual to infections. This may be due to a congenital disease called heterotaxy disease. However, this may also be acquired after birth especially in cases of splenectomy.












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