The Spleen
PKGhatak,MD
The spleen is the most underappreciated organ in the human body. Even people gave it a bad rap like “to vent one’s spleen”- meaning vent anger; sadness and melancholy were associated with the spleen. Greek and Chinese were more generous with the spleen- they associated the spleen with good-heartedness and strong willpower. Medical books describe the spleen as the headquarters of the Reticulo-Endothelial System. What is that?—you know lymph nodes and lymphatics; the spleen is rich in both.
The spleen is not a good looking organ. It is a kind of mottled purplish gray in color, about 3 inches from side to side and 4 inches vertically, and 2 inches in thickness. It weighs less than 1/2 pound. The spleen is hidden under the left rib cage, way deep inside the abdomen, resting below the diaphragm. The top of the left kidney is resting on it, the tail of the pancreas is touching it and the stomach is smoothly gliding over it.
If you imagine shrinking yourself to a tiny size like an RBC (red blood cell) and enter the spleen you will immediately find yourself lost in an area like bogs in Louisiana. Pools of blood are everywhere and there are islands of cells of various sizes all along the lakes, channels, and streams. In the central part, it has a kind of white appearance and as you travel further away towards the distal end you see it is turning to a red color.
In the white area where Lymphocytes are manufactured and the red area where the cells are checking everything that enters the spleen like airport security officers do by scanning, patting and strip searching. What are they doing?- removing deformed or broken RBCs, bacteria, parasites and other disease causing agents that are marked by a coat of protein; then giving them to macrophages which eat them alive. The disease fighting antibodies are produced by B- lymphocytes and the spleen is the site- like a factory. It is also a source of T-lymphocytes
The human spleen has lost its ability, in the course of evolution, to inject a fresh supply of RBC in circulation in times of need like the sudden spurt of physical activities e.g. hunting or racing. Dogs and horses are able to do that. In human, the spleen stores a good quantity of Platelets and some White Blood Cells; and release them into circulation when required.
You will not find the spleen creating much fuss; it keeps on doing its good work very efficiently, unseen, and without a murmur. In traffic accidents, people may sustain crush injuries to the rib cage and the spleen may be lacerated. And the spleen may be bruised in a football game. In diseases like Leukemia, Thalassemia, and Sickle cell anemia and in acute infections like mononucleosis, septicemia and chronic malaria you may find significant enlargement of the spleen. An enlarged spleen may produce dull aches under the rib cage.
The spleen is like brain tissue, when damaged it can not be properly stitched together; it may bleed continuously. A lacerated spleen has to be removed surgically. Once it is gone its function, to a certain extent, is taken over by the Liver. But the disease fighting quality remains inadequate. Certain bacterial and parasitic infections are common in an asplenic individual. More frequent vaccinations for certain diseases are required.
I believe, now, you may be ready to pay a tribute to one of the unsung heroes of our amazing body.
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