The spleen is the largest lymphoid organ, a soft fist-sized organ in the upper left abdomen tucked under the ribs (ribs 9-11) behind the stomach. Its red pulp filters the blood, removing old or damaged red cells, while its white pulp is packed with lymphocytes that respond to blood-borne infections. It also stores a reserve of platelets.
| Location | Left upper quadrant (left hypochondrium), under ribs 9-11 with its long axis along the 10th rib, between the fundus of the stomach and the diaphragm, above the left colic flexure and in front of the left kidney |
|---|---|
| Secretes |
|
| Nerve Supply | Coeliac plexus (sympathetic) |
| Blood Supply | Splenic artery |
| Venous drainage | |
| Lymphatic drainage |
Filters blood, removing worn-out red cells, platelets and blood-borne microbes; mounts immune responses, especially antibody responses to encapsulated bacteria; stores platelets and monocytes and can make blood cells in disease.
The spleen is the most commonly injured abdominal organ in blunt trauma, and rupture can cause life-threatening bleeding with left shoulder tip pain (Kehr sign); many injuries are now managed without surgery. Athletes with glandular fever (infectious mononucleosis) are advised to avoid contact sport for several weeks because the enlarged spleen ruptures more easily. After splenectomy people are vulnerable to severe infection with encapsulated bacteria and need vaccinations and sometimes antibiotics.
Laceration of the spleen from blunt trauma or minor trauma to an enlarged spleen, causing internal bleeding and shock.
Enlargement of the spleen from infection, portal hypertension, blood cancers or haemolytic anaemias, palpable below the left costal margin.
Rapid, often fatal sepsis from pneumococcus or other encapsulated organisms in people without a functioning spleen.
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