Q: I am confused. My friend recently was in an auto accident and had his spleen removed because of the trauma. How can we live without a vital organ?
A: The spleen is an sponge-like organ about the size of your fist located just underneath the left side of the rib cage. It is comprised of two basic forms of tissue, white pulp and red pulp, with each having a different function in the body. The white pulp is part of an immune system that acts to fight infection. It produces lymphocytes, white blood cells that produce antibodies which are specialized proteins that protect us against invasion of foreign substances. The red pulp filters our blood and discards unwanted material. It serves as a holding tank of sorts for various elements of blood, particularly white blood cells and platelets, it monitors our red blood cells and destroys those that are damaged or too old to function properly.
Despite the complex-sounding function of the spleen, we can actually live without it if it is destroyed because of an injury such as an automobile accident or other trauma. When this occurs, the body naturally loses some of its ability to produce protective antibodies, making us more prone to infection. As with such situations as a blocked artery in which other smaller blood-carrying vessels step up to the plate, the body is truly a miraculous thing. In most instances when a person has no spleen, the liver and other organs such as the bone marrow take over and compensate for the loss by increasing their ability to fight infection and by acting as sentinels for removing blood cells that are old, damaged, or otherwise abnormal. The individual who has had his or spleen removed in a surgical procedure known as a splenectomy will be conscientious about receiving vaccinations to protect against infection and may also be prescribed antibiotics to help prevent infection.
As a point of information, there are a number of disorders including anemias, cancers, infections, and mononucleosis that can cause a spleen to enlarge. The condition known as splenomegaly is not a disease in itself. Symptoms are not specific but a patient may experience pain or a feeling of fullness in the back or upper left abdomen. A physician can generally palpate spleen enlargement but imaging tests such as an ultrasound may be ordered to determine just how large the organ is.
A ruptured spleen generally occurs as a result of blunt force trauma such as a strong blow to the abdomen from a fight, sports injury, or auto accident. Other possible causes include surgical errors and while rare in comparison, medical procedures such as a colonoscopy, infectious and hematological diseases, pregnancy and medications. Symptoms of minor injuries with minimal bleeding may include lightheadedness, pain and tenderness in the upper left area of the abdomen. With more traumatic cases, there could be extensive bleeding that causes a rapid pulse, hypovolemic shock, a drop in blood pressure, confusion, and more. Some ruptures may require a few days of hospitalization for observation of ongoing bleeding, while others are a true emergency because of the potential for a life-threatening internal bleed.