Localization
Pain in the spleen is usually located in the left upper abdomen at the level of the navel. However, the pain may also radiate into the lower abdomen below the navel or even into the left shoulder. Radiating splenic pain usually occurs in colicky splenic pain. Colic is a wave-like severe pain that is often described as a contraction.
Pain quality/intensity
The pain in the spleen is often described as stabbing, with more or less intensity. The pain can be continuous, recurring or sudden.
Causes
The causes of splenic pain are manifold. They can be the following causes: This is specifically an inflammation of the spleen capsule. In a splenic infarction, one or more splenic vessels become blocked, resulting in an undersupply of this area of the spleen.
A splenic infarction can lead to pain radiating into the groin.
- Splenic inflammation:
- Splenic infarction:
An accident or fall can cause a rupture in the spleen. A distinction is made between a one-stage and a two-stage rupture of the spleen.
In a single-stem rupture of the spleen, there is a simultaneous injury to the spleen capsule and spleen tissue, resulting in direct bleeding into the abdominal cavity. In a two-step splenic rupture, the splenic tissue is injured first, and only later does a rupture of the capsule occur with bleeding into the abdominal cavity. The rupture of the spleen can be very dangerous, as there can be a rapid loss of blood due to internal bleeding, so the main concern is to stop the bleeding as soon as possible.
In addition, the spleen must be partially or completely removed. In the case of enlarged spleen in combination with splenic pain, the following causes are possible: Infections with enormous swelling of the spleen are mainly malaria. However, EBV (Epstein-Barr infection, also known as Pfeiffer’s glandular fever), HIV infection, rubella, toxoplasmosis (a common parasitic disease transmitted by cats and their feces), and bacterial endocarditis (inflammation of the inner lining of the heart) can also cause swelling of the spleen and pain.
Spleen enlargement or swelling also causes pain, as the enlarged spleen presses against its capsule and surrounding organs and structures.
- Infections:
- Spleen tumor or swelling of the spleen:
Metabolic diseases also include various storage diseases, which are caused by disorders of enzymes, mutations or other errors in the metabolic cycle. This can be caused by different blood cells.
Malignant diseases of the white blood cells are lymphoma or acutely occurring changes in the blood cells with many immature cells: leukemia. As a rule, lymphoma is often a chronic, long-term disease of the white blood cells. Blood cell cancer is discovered by a blood count, sampling and bone marrow tests.
- Metabolic diseases:
- Blood cell cancer:
Congestive processes in the spleen can be triggered mainly by portal vein hypertension. Portal vein hypertension is high blood pressure in the main vein leading to the liver, which transports blood from the intestines, pancreas and stomach. Due to the blood congestion, it can back up into the spleen system and thus lead to a swelling of the spleen.
This can lead to splenomegaly and pain, particularly in juvenile rheumatoid arthritis (an inflammatory joint disease that occurs mainly in adolescence). These can be daughter ulcers (metastases in the spleen), blood cell cancer see above. A rare autoimmune disease such as lupus erythematosus can also be the cause. There are also diseases of the red blood cells such as sickle cell anaemia or thalassemia.
- Congestive processes in the spleen:
- Rheumatic diseases:
- Cancer diseases:
- Rare diseases:
