Spleen

A. Sandhya -

Structure

The spleen is part of the lymphatic system, which fights infections and keeps body fluids in balance. It is a small organ located in the upper left abdominal cavity, just beneath the diaphragm, and posterior to the stomach. It is a fist-shaped, purple coloured, highly vascular ductless organ, protected by the rib cage.
In healthy adult humans, it measures approximately 7 centimeters (2.8 in) to 14 centimeters (5.5 in) in length, 8cm broad and 3-4 cm thick weighing about 200gm. It may vary in size and weight during the lifetime of an individual.

The spleen is the largest lymphatic organ in the body and it consists of two types of spongy tissues called white pulp and red pulp.
The white pulp is lymphatic tissue consisting mainly of lymphocytes and red pulp consists of sinuses filled with blood and cords of lymphatic cells, such as lymphocytes and macrophages.
The spleen has an outer coat of peritoneum which is firmly attached to the inner coat or splenic capsule that dips into the organ, forming trabeculae.

Functions of Spleen

The spleen serves several functions in the body.

  • The main function of the spleen is to filter the blood, and keep  the blood circulating in the body clean. During the filtration process, it detects, breaks down and removes cells that are abnormal, old, or damaged and also microorganisms and particulate antigens from the bloodstream.
  • The lifespan of RBC is 100 --120days. After the completion of life span, red blood cells are destroyed in the spleen. So, spleen is also described as Graveyard of RBC.
  • Once the red blood cells are broken down, the spleen stores useful leftover products, such as iron and it also stores platelets and white blood cells.
  • It also plays a role in the immune response by detecting pathogens such as bacteria, and helps fight with them by producing white blood cells in response.
  • During the development of the fetus, it synthesizes red blood cells, but after the fifth month of gestation, this function is stopped

If the spleen is not working properly, it may remove healthy blood cells and this can cause reduction in red blood cells, causing anaemia (a condition in which the number of red blood cells circulating in the bloodstream is lower than usual), reduction in white blood cells leading to increased risk of infection and reduction in number of platelets causing bleeding or bruising.
A damaged or ruptured spleen after an injury causes, severe internal bleeding, pain behind left ribs, dizziness, rapid heart rate due to low blood pressure caused by blood loss, pale skin, fatigue
A ruptured spleen can also cause life-threatening bleeding, so it requires a medical emergency.
The spleen can become swollen or enlarged (Splenomegaly) after an injury, or infections caused by virus, bacteria, parasites such as malaria or diseases like cirrhosis (liver disease), lupus or rheumatoid arthritis (inflammatory diseases), blood cancers or heart failure.
Enlarged spleen or Splenomegaly may cause, frequent infections, easy bleeding, anaemia and fatigue due to blood loss, prolonged headache, dizziness, tired eyes, headache, dizziness, tired eyes, feeling discomfort or pain behind left ribs, pain or discomfort in the left shoulder, weak limbs and little desire to speak.
An enlarged spleen can also cause spleen cancer. Some complications of the cancer are pain or fullness in the upper abdomen and cold.
Enlarged spleen may store too many platelets, leading to decrease in platelets in the body’s circulatory system (Thrombocytopenia). Due to this blood can not clot and cause bleeding. In some cases, these symptoms may not be observed

Asplenia is loss of splenic function due to absence of the spleen at birth or splenectomy (Surgical removal of the spleen) or a disease,
and the diseases related to loss of splenic function are,

  • Gastrointestinal (GI) disorders such as Celiac disease, Whipple disease, and inflammatory bowel diseases (IBD)
  • Infectious diseases and acquired immune deficiency syndromes like HIV
  • Hepatic disorders such as alcoholic liver disease, cirrhosis, portal hypertension, and hepatorenal syndrome.
  • Rheumatologic conditions such as systemic lupus erythematosus (SLE)

If the spleen does not function properly due to various diseases like  sickle cell disease, celiac disease, and alcoholic liver disease or due to an injury to the arteries or veins of the spleen, such condition is called Functional asplenia.
When the spleen is removed or does not function, the body's ability to fight infections is impaired and the risk of infections raises.
Splenic infarction is the death of tissue in the spleen due to the blockage in blood flow, causes fever and chills, severe pain in the left upper quadrant of the abdomen, sometimes radiating to the left shoulder.
Splenic infarction leads to a ruptured spleen, bleeding and the abscess of the spleen or pseudocyst formation.
The tissue from the spleen breaks off and implants at another site inside the body. This condition is called Splenosis and it causes abdominal pain, intestinal obstruction, hemorrhage (Bleeding or loss of blood), or hydronephrosis (swelling of a kidney due to a build-up of urine caused by a blockage in the tube that connects the kidney to the bladder)
Wandering spleen is a rare condition where the spleen is not found in its normal location. This is due to the absence or underdevelopment of one or all of the ligaments that hold the spleen in its normal position or or due to the abnormal relaxation (laxity) of the ligaments due to the pregnancy.
The complications include acute abdominal pain, fever, vomiting, acute pancreatitis, and gastric compression.
Polysplenia is a congenital disease manifested by multiple small accessory spleens, rather than a single, full-sized, normal spleen. It results in congenital heart defects, intestinal malrotation or twisting of intestine which can cause blockage, vague abdominal pain due to malrotation.
Sickle cell anemia is a form of anemia, in which abnormally shaped (crescent-shaped) red blood cells  block the flow of blood, causing damage to the spleen.
Accessory spleen: 10–15 percent of people have an additional spleen and the second spleen is usually much smaller in size and causes no health problems.
A person can live without a spleen because other organs, such as liver, will take over some of the spleen's functions

Precautions

To keep spleen healthy,

  • cold drinks and ice in beverages should be avoided
  • food has to be chewed slowly and thoroughly
  • warm, veggie-abundant soups and broths are to be preferred
  • small, frequent meals have to be taken.
  • foods that are warm in nature should be chosen
  • raw vegetables which make spleen work harder should be avoided
  • foods that are too hot in nature are to be avoided
  • regular mealtimes are to be followed
  • going to bed immediately after eating has to be avoided as the food cannot be digested well while sleeping.

Foods That Support Spleen

  • Green tea, jasmine tea, raspberry leaf tea, chai tea
  • Aloe vera gel and juice
  • Grapes, Pomegranates
  • Ginger, pepper, cardamom, onions, garlic, cinnamon, clove, fennel, rosemary, turmeric, thyme, horseradish, and nutmeg
  • carrot, turnip, sweet potato, yam, pumpkin
  • kidney beans, lentils, black beans, and peas
  • Sesame seeds