The spleen is considered the largest immune organ in the body and is located in the left upper abdomen, where its longitudinal axis extends along ribs 9-10-11. It weighs about 150 grams in children and may reach up to 250 grams in adults.

Where is the spleen located?

The spleen is located below the left rib cage in the upper left quadrant of the abdomen, where it is adjacent to the stomach from the front and is in contact with the tail of the pancreas from the back.

What is the function of the spleen?

The functions and benefits of the spleen in the body are numerous, the most important of which is its immune function. The spleen contains a high proportion of T and B lymphocytes in addition to being the main site for producing immunoglobulins. It also contributes to the formation of some blood cells in the fetus starting from the fourth month of intrauterine life. The spleen also filters the blood by removing damaged red blood cells and old platelets and impurities from blood cells.

Is the spleen the same as the pancreas?

The spleen and pancreas are two completely different organs and the pancreas is located behind the spleen inside the abdomen. The primary function of the pancreas is to control blood sugar levels and digest fatty foods, while the primary function of the spleen is immune.

What is the normal size of the spleen in centimeters?

The size of the spleen varies according to age, as it can reach up to 10×7×3 cm in older adults and less than that in children. Any increase in size beyond this can cause compressive symptoms inside the abdomen.

Can the spleen return to its normal size?

It is possible for the spleen to return to its normal size after treating the underlying cause of its enlargement, such as liver and blood diseases.

Is splenomegaly dangerous?

Splenomegaly can be dangerous if the patient is not provided with adequate treatment, as the enlarged spleen is more susceptible to bleeding than a normal spleen.

Does stomach bacteria cause spleen enlargement?

There is no clear relationship between infection with stomach bacteria and spleen enlargement, but it may cause a decrease in blood platelets.

Does spleen enlargement cause shortness of breath?

An enlarged spleen can cause shortness of breath if it causes severe anemia due to a lack of oxygen-carrying red blood cells.

Does splenomegaly cause death?

In a few cases of untreated severe splenomegaly, the spleen can rupture and the child can bleed so badly that death occurs.

What should a patient with splenomegaly eat?

A patient with spleen enlargement should eat a lot of fruits and vegetables rich in antioxidants, such as broccoli and spinach, in addition to eating fish rich in Omega-3, which has an anti-inflammatory effect. He should also not eat excessively in red meat and dairy derivatives because they are rich in fats, which negatively affects his health.

Enlarged liver and spleen in children, is it dangerous?

Symptoms of enlarged liver and spleen in children are more serious than in adults because they can affect the child’s normal development and immunity as well.

Pediatric Splenomegaly Treatment in Turkey

Table Of Contents

What is pediatric splenomegaly?

Pediatric splenomegaly symptoms

Pediatric splenomegaly causes

Pediatric splenomegaly diagnosis

Pediatric splenomegaly complications

Pediatric splenomegaly Treatment

Pediatric splenomegaly is spleen enlargement in children caused by blood disorders, leading to discomfort and fullness in the spleen area.

Pediatric splenomegaly is a common complaint at this age, as it can be accompanied by blood diseases, especially in addition to liver diseases. However, not all pediatric splenomegaly indicates a medical condition, as it is possible for a child’s splenomegaly to be completely healthy and not require treatment.

What is pediatric splenomegaly?

The spleen in the human body is an organ located in the upper left quadrant of the abdomen below the rib cage. Its size increases with age, but it is usually not palpable except in certain cases, such as a thin or premature baby (born before 37 weeks of pregnancy).

Spleen Location In The Human Body And Its Relationship To The Ribs — Spleen Location In The Body And Its Relationship With The Ribs

Pediatric splenomegaly, or palpating a mass in its place, and some people may call it a splenic disease in children as it is the most common disease that affects the spleen. It is one of the medical conditions that require immediate intervention by doctors to determine the cause of splenomegaly and how to treat it if certain symptoms appear in the child.

Pediatric splenomegaly symptoms

The majority of cases of pediatric splenomegaly are asymptomatic and are detected incidentally during routine clinical examination of the child. However, it is possible to manifest with one of the following symptoms and signs:

Abdominal distension.
Jaundice (yellowing of the skin).
Spleen pain and crying, especially when palpated during a clinical examination.
In cases of severe pediatric splenomegaly, it can compress the spleen’s blood vessels, affecting its blood supply and thus causing blood filtration disorders. It can also compress the stomach and cause symptoms and pain, especially after eating.
Anemia leads to pallor because the enlarged spleen removes red blood cells significantly and does not produce enough white blood cells, which negatively affects the body’s immunity, causing more infections and diseases.

The Difference Between A Normal Spleen And An Enlarged Spleen — Comparison Of A Normal Spleen And An Enlarged Spleen

Pediatric splenomegaly causes

There are many causes or diseases that lead to pediatric splenomegaly, some of which cause temporary splenomegaly that is treatable, and some cause permanent splenomegaly. The most important causes of pediatric splenomegaly are:

Pediatric splenomegaly infectious causes

The most common infectious causes that can cause pediatric splenomegaly are bacterial infections that can lead to splenic inflammation in children and then enlargement. The most prominent of these bacteria include:

Typhoid and paratyphoid Salmonella
Rickettsia causing typhus
Syphilis
Tuberculosis: It can cause splenic enlargement in immunocompromised children and those with other diseases.

In some cases, a splenic abscess may form after bacterial infection, which causes splenomegaly in children, and compression symptoms may appear in the abdomen. Blood infection can also occur, a serious condition requiring immediate treatment.

Pediatric Enlarged Spleen (Multiple Occult Intrasplenic Abscess) — Pediatric Splenomegaly Ultrasound (Multiple Occult Intrasplenic Abscess)

Among the viral causes, we mention infectious mononucleosis and immune thrombocytopenia virus, in addition to parasites such as blood schistosomiasis, filariasis, malaria, and echinococcus granulosus, which causes water hydatid cyst.

Pediatric splenomegaly blood-related causes

There are numerous blood diseases that cause pediatric splenomegaly, but the spleen may not be palpable during clinical examination. The most prominent of these diseases are:

Acute leukemia
Chronic leukemia
Thalassemia
Idiopathic thrombocytopenic purpura
Autoimmune hemolytic anemia
Hereditary spherocytosis
Sickle cell anemia
Iron deficiency anemia

Pediatric splenomegaly metabolic causes

Gaucher’s disease is the most important metabolic disease that can cause pediatric splenomegaly.
Amyloidosis
Goucher’s disease
Niemann-Pick disease

Pediatric splenomegaly circulatory causes

Any obstruction and increase in tension within the portal vein in the context of other diseases can cause pediatric 6splenomegaly. There may be an increase in tension in the portal vein if a thrombus forms in the splenic vein or if cancer forms in the pancreas.

Pediatric splenomegaly tumor-related causes

Splenomegaly in children may occur in many hematological tumors, the most important of which are:

Lymphoma (especially Hodgkin’s lymphoma)
Vascular tumor
Primary fibrous tumor
Pure red cell aplasia (a rare type of bone cancer)

Other causes

Still’s disease (systemic juvenile idiopathic arthritis in children)
Non-parasitic splenic cysts

Pediatric splenomegaly diagnosis

The diagnosis of pediatric enlarged spleen is primarily based on palpating the upper left quadrant of the abdomen during clinical examination of the child, where the spleen can be palpated in infants and young children but is often pathological in older children.

In some cases, a number of laboratory tests can be used to confirm the diagnosis of splenomegaly, such as a complete blood count that shows the number of white and red blood cells in addition to platelets. Liver enzyme analysis may also be requested if there is suspicion that the cause of splenomegaly is liver disease.

In some cases, radiological methods may be used to determine the size of the enlarged spleen in children and its relationship with adjacent organs. The most prominent of these methods are:

Ultrasound imaging (Echo): characterized by its speed compared to other radiological imaging methods.

Abdominal CT: It can accurately determine the size of the spleen and its relationship with adjacent organs.

Pediatric Enlarged Spleen (Abdomenal Ct Scan) — Pediatric Splenomegaly (Abdomenal Ct Scan)

MRI: It can track the movement and flow of blood through the organ being examined.

To determine the underlying cause of splenomegaly, a solid bone marrow biopsy or a fluid sample may be taken, or both, where both samples are taken from the hip bone under local or general anesthesia.

Taking a biopsy of the spleen with a needle has become rare due to the high risk of bleeding during this procedure. In some cases, if the cause of splenomegaly cannot be determined, the doctor may recommend removing the spleen as a diagnostic procedure to determine the true cause of enlargement.

Pediatric splenomegaly complications

If left untreated, pediatric enlarged spleen can lead to negative and life-threatening consequences. The most important complications that may occur are:

Frequent infections
Anemia
Frequent bleeding
Spleen rupture (patients with splenomegaly are more prone to rupture)

Pediatric splenomegaly Treatment

The treatment of pediatric enlarged spleen varies depending on the underlying cause of the spleen enlargement. However, we often resort to surgical intervention in which the spleen is removed from the abdomen, known as splenectomy, which has become widely performed in Turkey.

Antibiotics may suffice if the cause of spleen swelling in children is a bacterial infection. As for blood diseases such as thalassemia and sickle cell anemia, blood transfusion is of great importance in treating the disease.

Surgical treatment remains the best treatment for an enlarged spleen in cases of tumors and cancerous masses, where we often have to completely remove it to control the symptoms caused by the spleen tumor.

Finally, it should be noted that if there are no accompanying symptoms of splenomegaly in children, such as pain in the spleen or symptoms that affect the child’s normal growth, then periodic monitoring every 6-12 months may suffice for treating mild splenomegaly depending on the child’s condition and the cause of their spleen enlargement. Severe splenomegaly often requires splenectomy in Turkey.

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