If the cause of an enlarged spleen can be identified, treatment focuses on the underlying problem. For example, if you have a bacterial infection, treatment will include antibiotics.
If you have an enlarged spleen but don't have any symptoms and the cause can't be found, your doctor may suggest watchful waiting. You'll have to see your doctor for revaluation in six to 12 months, or sooner if you develop any symptoms.
If an enlarged spleen causes serious complications or the underlying problem can't be identified or treated, surgical removal of your spleen (splenectomy) may be an option. In fact, in chronic or critical cases, surgery may offer the best hope for recovery.
But elective spleen removal requires careful consideration. You can live an active life without a spleen, but you're more likely to contract serious or even life-threatening infections after having your spleen removed. Sometimes radiation can shrink your spleen so that you can avoid surgery.
Reducing infection risk after surgery
If you do have your spleen removed, certain steps can help reduce your risk of infection, including:
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- A series of vaccinations both before and after the splenectomy. These include the pneumococcal (Pneumovax 23), meningococcal and haemophilus influenzae type b (Hib) vaccines, which protect against pneumonia, meningitis, and infections of the blood, bones and joints. In addition, you'll need to get the pneumococcal vaccine every five years after surgery.
- Taking penicillin or other antibiotics after your operation and anytime you or your doctor suspects the possibility of an infection.
- Calling your doctor as soon as you know that you have a fever because this may indicate an infection.
- Avoiding travel to parts of the world where certain diseases, such as malaria, are endemic.
- Landaw SA, et al. Approach to the adult patient with splenomegaly and other splenic disorders. http://www.uptodate.com/home. Accessed June 6, 2013.
- Splenomegaly. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/hematology_and_oncology/spleen_disorders/splenomegaly.html. Accessed June 6, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed June 6, 2013.
- Pozo AL, et al. Splenomegaly: Investigation, diagnosis and management. Blood Reviews. 2009;23:105.
- Recommended Adult Immunization Schedule: United States — 2013. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/schedules/hcp/adult.html. Accessed June 6, 2013.