How do I feel a swollen spleen?

In healthy people the spleen is generally not palpable. It is hidden above the left kidney under the left costal arch. If the organ swells, it may protrude below the left costal arch and then be palpable.

In case of a strong enlargement, the spleen can reach very far down into the abdominal cavity. In order to palpate the spleen, one can take a deep breath and palpate deeply with a few fingers just below the costal arch. At the end of the inhalation or at the beginning of the exhalation, it may be possible to feel how the edge of the spleen slides out from under the costal arch or how it disappears again under the costal arch. During deep inhalation, the spleen is moved downwards, during exhalation it is moved upwards again.

Associated symptoms

The symptoms accompanying a spleen enlargement depend very much on the underlying disease. Initially, the swelling of the spleen can be noticeable as a pulling and pressing pain in the left upper abdomen, which can be accompanied by stomach problems and breathing difficulties. In the long term, a functional impairment of the spleen can lead to an increased susceptibility to infections, thromboses and changes in the blood count.

In the course of the disease, the swelling of the spleen may progress, resulting in a threatening rupture of the spleen. In addition to pain, this can lead to slow bleeding symptoms with weakness, fainting and impaired performance, which can be a life-threatening clinical picture. The numerous causes of splenic swelling can lead to further symptoms.

Important accompanying symptoms that require further clarification are fever, cough, swelling of the lymph nodes, fatigue, weight loss or night sweats. In the presence of Pfeiffer’s glandular fever, fever, flu-like symptoms, swelling of the lymph nodes, swelling of the pharyngeal tonsils with sore throat, as well as marked fatigue and exhaustion may occur. In malaria, cyclical fever attacks lasting several days are a relatively typical symptom.

If a weak heart is responsible for the swelling of the spleen, there may be shortness of breath at low exertion. If leukaemia is the cause of an enlargement of the spleen, symptoms such as increased susceptibility to infection, exhaustion and reduced performance, frequent occurrence of bruises and night sweats may occur. Lymph node swelling often occurs in various regions.