Spleen problems

The spleen is an organ found in the upper left side of your abdomen (tummy).

Your spleen has 3 main roles:

• it filters your blood
• supports your immune system
• stores iron, red blood cells and platelets

This helps keep your blood healthy and protects you from infection.

Spleen problems can affect the spleen's size, position or how well it works.

Some people do not have a spleen. This is called asplenia.

Other people have a spleen that does not work properly. This is called hyposplenia or hyposplenism.

Other spleen problems include:

• splenomegaly — your spleen is bigger than normal, which is often a sign of another health problem
• hypersplenism — when your spleen becomes overactive and breaks down too many blood cells
• accessory spleen — you have a small extra spleen
• congenital polysplenia — you are born with several extra small spleens
• splenosis — small pieces of spleen tissue grow elsewhere in the abdomen after your spleen is injured
• splenoptosis — the spleen sits lower in your tummy than it should

Spleen problems may happen when the spleen is missing or does not work properly. Some people are born with spleen problems. Others develop them because of illness, injury or surgery.

Asplenia

Asplenia may happen if you were born without a spleen (congenital asplenia).

It may also happen because your spleen was removed during surgery called splenectomy.

Hyposplenia

Hyposplenia may be caused by:

• blood disorders — such as sickle cell disease and cancers of the blood or lymph system
• autoimmune conditions — such as systemic lupus erythematosus, rheumatoid arthritis and Hashimoto's disease
• gastrointestinal diseases — such as coeliac disease and Crohn's disease
• liver conditions and diseases
• conditions that affect blood flow to or from the spleen
• certain medicines

Spleen problems do not always cause clear symptoms. Some people feel well and the problem is only found during a physical check or imaging scan. The symptoms you have depend on what's causing the spleen problem.

When symptoms do happen, they may include:

• fever, shivering or chills — this can be a sign of infection
• feeling unwell
• pain or discomfort in the upper left side of your tummy, sometimes after an injury or fall
• yellowing of the skin or eyes (jaundice) — this may be linked to liver problems that affect the spleen
• easy bruising or bleeding
• swollen glands (lymph nodes) in the neck, armpits or groin

In some conditions, the spleen can suddenly trap large amounts of blood. This may cause sudden pain and make you feel unwell. This needs immediate treatment.

See your doctor if you have sudden pain in the left upper side of your tummy. Also see your doctor if you have had an accident, fall or other injury to your tummy and notice pain.

See your doctor if you have spleen problems and plan to travel overseas. Ask for travel health advice about:

• malaria, salmonella and babesiosis (a rare parasitic infection spread by ticks)
• when to see a local doctor
• extra vaccines that you may need

When to seek urgent care

Spleen problems are diagnosed through a physical check and tests.

Medical history and symptoms

Your doctor may ask about:

• your symptoms
• recent travel to areas where malaria is common
• family health history of blood disorders

Physical examination

An enlarged spleen may be felt during a tummy examination.

Tests

Tests may include:

• blood tests
• imaging tests — such as an ultrasound, MRI scan or CT scan
• immune tests — done by an immunology specialist

Treatment depends on what's causing the spleen problem. Often, the condition causing the spleen problem is treated.

Medicines

Medicines may be used to treat the cause of your spleen problem. Autoimmune conditions may be treated with medicines that calm the immune system, such as corticosteroids.

Antibiotics are important for people without a working spleen. You may need daily antibiotics for several years, or for the rest of your life.

Surgery

A splenectomy is surgery to remove all or part of the spleen. It is usually only done when other treatments have not worked or when the spleen causes serious problems.

If you are living with spleen problems, here are tips that may help:

• Learn the signs and symptoms of an infection.
• Learn when to use emergency antibiotics.
• Stay up to date with your vaccines.
• Have a written care plan and share it with your family and healthcare providers.
• Carry your medical alert card or wear a medical alert ID.
• Let all your doctors know you do not have a spleen.
• Seek travel advice before overseas travel.

If you or your child is living with spleen problems, family members and close contacts should also be fully vaccinated.

Spleen problems, especially if your spleen is removed (splenectomy), may lead to complications.

Common complications include serious infections and blood clots. Other possible complications include anaemia or rupture of the spleen.

Serious infections

People living without a functioning spleen have a high chance of serious infections. This is because the spleen helps fight bacteria. Common infections include infections of the:

• lungs (pneumonia)
• blood (sepsis)
• brain (meningitis)

Infections may become severe quickly and may lead to a condition called overwhelming post-splenectomy infection (OPSI). This may be life-threatening.

Because you have a high chance of OPSI, prevention is important. These tips can help reduce your chance of serious infection:

• Stay up to date with your recommended vaccinations. You may need booster vaccines and a yearly flu vaccine. See your GP to review your vaccines.
• Take preventative antibiotics as prescribed. Some people may need antibiotics for several years. Others may need them for life. You should also have an emergency supply of antibiotics at home or when you travel.

If you are living with spleen problems and have signs of an infection, call triple zero (000) immediately and ask for an ambulance.

Travel-related infections

People without a functioning spleen are more likely to get sick from certain infections when travelling. These include:

• malaria
• salmonella
• babesiosis (a rare parasitic infection spread by ticks)

Animal bites and scratches

Bacteria live in the mouths or claws of animals like cats and dogs. These can be dangerous for people without a working spleen.

If you get bitten or scratched by an animal:

• wash the area straight away with soap and water
• apply an antiseptic
• watch for signs of infection, such as redness, swelling, pain or pus
• seek medical advice

Many spleen problems cannot be prevented, for example if they happen because of another disease you can't prevent. Some conditions that affect the spleen can be prevented, for example, some blood conditions.

• Spleen Australia (Opens in new tab) has information and support for people living with spleen problems, including living without a functioning spleen (Opens in new tab), vaccinations (Opens in new tab), travel advice and help for families affected by spleen problems.
• HealthyWA has information about conditions that affect the spleen (Opens in new tab).
• NSW Health has information about care after spleen removal (Opens in new tab).
• Smart Traveller (Opens in new tab) has the latest information and advice about travelling overseas.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.