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Spleen Injuries Can Be Very Dangerous

DEAR DR. PAUL: What does the spleen do? I recently heard about a hockey player who had to have his spleen remove. Can people live without a spleen?

DR. PAUL Answers: The spleen is an organ found in the abdominal area, located just below the ribs on the left hand side. Ordinarily, the spleen filters out infection and other unwanted particles from the blood. The spleen is part of the lymphatic system which plays an important role in protecting the body. Just like lymph nodes, the spleen will grow in size in the face of an infection. Infectious mononucleosis (mono), a viral illness commonly seen in teenagers, is one of the most common causes of spleen enlargement. The spleen enlarges as if engulfs or literally "eats up" invading germs and other particles. Other conditions that cause an enlarged spleen include red blood cell diseases such as Sickle Cell Anemia and Thalassemia and more rarely, lymphoma (cancer of the lymphatic system). In the case of blood diseases, the red cells are abnormal and die off quicker and in a larger quantities than normal. The spleen cleans up this so called "red-blood-cell debris". In such cases of excessive amounts of debris the spleen works overtime and becomes enlarged. The same situation can occur in infections of red blood cells such as Malaria. In this case, the malaria parasite enters into the red blood cells and causes them to break up. Still in other cases, for reasons we do not understand, the spleen works harder than it should, collecting normal cells. An example is ITP (Idiopathic Thrombocytopenic Purpura. In ITP the platelets, cells which help clot our blood, get sequestered or collected by the spleen. The result is that the number of platelets decreases to often dangerously low numbers resulting in easy bleeding.

Now to your question about spleen injuries; Because of its location, the spleen is prone to getting injured. The spleen can either be injured directly by the impact or by a fractured rib on the left side. The most common cause of injury is a car accident. Less commonly, in contact sports such as ice hockey during a body check or slamming into the boards, the spleen can also be injured. The impact of the injury can actually cause the spleen to rupture, resulting in massive amounts of bleeding into the abdominal area. This situation is potentially life-threatening and is considered a medical emergency. The only treatment, is to remove the spleen and repair any other damage surgically. This happened recently to a professional hockey player, who thankfully survived the whole ordeal and is now fine. So, yes people can live without a spleen. However, they are more prone to certain infections, and will need to receive vaccinations or even preventative antibiotics .

On a final note, it is important to be aware that any injury to the abdominal area or left side of the rib cage, can involve the spleen. As a precaution, in cases where the spleen is temporarily enlarged, like in mono, contact sports should be avoided completely. Additionally, when participating in any contact sport,  appropriate and well-fitted protective equipment should always be worn.

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