From the Guidelines
Splenomegaly can cause pain, but not always, and the severity of the pain is often determined by the underlying cause of the splenomegaly. Many people with mild to moderate splenomegaly experience no symptoms at all [ 1 ]. When pain does occur, it's typically felt in the upper left abdomen or left shoulder and may worsen after eating [ 1 ]. The discomfort happens because the enlarged spleen stretches its capsule and can press against nearby organs. More severe splenomegaly may cause a feeling of fullness after eating small amounts of food due to the spleen pressing on the stomach.
Causes and Symptoms
The underlying cause of the splenomegaly (such as infections, blood disorders, liver disease, or cancer) often determines whether pain is present and its severity [ 1 ]. For example, splenic abscess, a rare complication of infective endocarditis, can cause pain in the back, left flank, or left upper quadrant, or abdominal tenderness [ 1 ]. In contrast, some cases of splenomegaly, such as those associated with myeloproliferative neoplasms, may be treated with hydroxyurea, which can reduce spleen volume and alleviate symptoms [ 1 ].
Treatment and Management
If you're experiencing abdominal pain, especially in the upper left area, it's essential to seek medical evaluation as an enlarged spleen can rupture with trauma, causing life-threatening internal bleeding. Treatment focuses on addressing the underlying cause rather than the splenomegaly itself [ 1 ]. In some cases, such as drug-refractory symptomatic splenomegaly, splenectomy may be considered as a viable treatment option [ 1 ].
Key Points
- Splenomegaly can cause pain, but not always
- The severity of the pain is often determined by the underlying cause of the splenomegaly
- Treatment focuses on addressing the underlying cause rather than the splenomegaly itself
- Splenectomy may be considered as a viable treatment option in some cases [ 1 ]
From the Research
Symptoms of Splenomegaly
- Splenomegaly can be asymptomatic, but it may cause hypersplenism, which can lead to thrombocytopenia and other complications 2
- The presence of hypersplenism is of little clinical consequence, and correcting it may not improve patient survival 3
- Splenomegaly itself is almost always a sign of a systemic condition, and its symptoms can suggest infectious, malignant, hepatic, or hematologic causes 4
Pain Associated with Splenomegaly
- There is no direct evidence in the provided studies that splenomegaly hurts, but it can cause complications such as splenic rupture, which can be painful 4
- The studies focus on the diagnosis, management, and treatment of splenomegaly, rather than the pain associated with it 4, 5, 6, 2, 3