Spleen Pain: Common Causes & Treatment

Updated in March 2022

Spleen pain is a type of abdominal pain that can occur with injury of this organ or if its size increases too much. You can often notice pain with coughing or with direct palpations. In these situations, in addition to pain, your doctor may notice abnormalities in your bloodwork. 

The spleen is found in the upper left quadrant of the abdomen. Its function is to filter the blood and remove injured red blood cells. It also produces and stores white blood cells from the immune system. 

Spleen pain can occur due to changes in its function as a consequence of illness or a rupture. The pain causes of spleen pain are: 

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1. Ruptured spleen

Although this is rare, a spleen can rupture due to car accidents, fist fights or with a broken rib. A spleen rupture is rare because of where it is located - it is protected by the stomach and the thoracic cage. When the spleen does rupture, symptoms may emerge like upper left abdominal pain, increased pain with palpation, dizziness, pallor or nausea. 

A ruptured spleen is a medical emergency that can result in a very serious hemorrhage, and therefore you should be assessed and treated immediately. 

2. Enlarged spleen

Some situations can stimulate changes to functioning in the spleen, like an increase or decrease in blood cell production. This occurrence usually results in an enlarged spleen. Conditions associated with increased spleen size include pernicious anemia, thalassemia, abnormalities to hemoglobin, rheumatoid arthritis, lupus, myelofibrosis, hemolytic anemia and thrombocytopenia.  

In addition the spleen can become larger in response to medications, or infections like AIDS, viral hepatitis, cytomegalovirus, tuberculosis, malaria or leishmaniasis. 

3. Liver problems 

Liver problems, like cirrhosis, hepatic vein obstruction, splenic artery aneurysm, congestive heart failure or portal vein hypertension can also result in an enlarged spleen with upper left abdominal pain. 

4. Cellular infiltration

Some illnesses can result in an enlarged spleen and cause pain, like amyloidosis, lymphoma, myeloproliferative syndrome, cysts and metastatic tumors. These illnesses are specifically characterized by cellular infiltration, which is the migration of foreign cells to this organ. 

How it is treated 

Treatment for spleen pain will depend on what caused the enlarged spleen in the first place, or in the case of a ruptured spleen, it should be immediately removed. Therefore it is important to confirm a diagnosis so that appropriate treatment can be initiated. In cases where the spleen pain is related to an infection, antibiotics may be required. Cancer-related pain may need to be treated with chemotherapy or radiation therapy. 

In more serious cases, the doctor may advise surgical removal of spleen, also known as a splenectomy. This procedure involves the partial or total removal of the spleen, and is usually performed in patients with cancer, a splenic rupture or splenomegaly.