Treatment

Treatment for an enlarged spleen focuses on the underlying problem. For example, if you have a bacterial infection, treatment will include antibiotics.

Watchful waiting

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 reevaluation in six to 12 months or sooner if you develop any symptoms.

Spleen removal surgery

If an enlarged spleen causes serious complications or the cause can't be identified or treated, surgical removal of your spleen (splenectomy) may be an option. In chronic or critical cases, surgery may offer the best hope for recovery.

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 spleen removal. Sometimes radiation can shrink your spleen so that you can avoid surgery.

Reducing infection risk after surgery

After spleen removal, certain steps can help reduce your risk of infection, including:

  • 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. You'll also need 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 at the first sign of a fever, because this may indicate an infection.
  • Avoiding travel to parts of the world where certain diseases, such as malaria, are common.
References
  1. Landaw SA, et al. Approach to the adult patient with splenomegaly and other splenic disorders. http://www.uptodate.com/home. Accessed June 14, 2016.
  2. Splenomegaly. Merck Manual Professional Version. http://www.merckmanuals.com/professional/hematology_and_oncology/spleen_disorders/splenomegaly.html. Accessed June 14, 2016.
  3. Longo DL, et al. Enlargement of lymph nodes and spleen. In: Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. Accessed June 14, 2016.
  4. Splenomegaly. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/003276.htm. Accessed June 14, 2016.
  5. Recommended adult immunization schedule: United States - 2016. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/schedules/hcp/adult.html. Accessed June 14, 2016.
  6. Enlarged spleen. The Merck Manuals: Merck Manual Consumer Version. https://www.merckmanuals.com/home/blood-disorders/spleen-disorders/enlarged-spleen. Accessed June 14, 2016.
  7. Computed tomography (CT) — Abdomen and pelvis. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?pg=abdominct#preparation. Accessed June 14, 2016.
  8. Magnetic resonance imaging (MRI) — Body. Radiological Society of North America. http://www.radiologyinfo.org/en/info.cfm?pg=bodymr#preparation. Accessed June 14, 2016.
  9. Bone marrow aspiration and biopsy. Lab Tests Online. https://labtestsonline.org/understanding/analytes/bone-marrow/tab/test/. Accessed June 28, 2016.
  10. Mesa RA (expert opinion). Mayo Clinic, Phoenix, Az. June 14, 2016.