Wednesday, January 04, 2006

Straight Talk About Your Spleen




The spleen is a relatively large organ that resides behind
and slightly under the stomach. It is deep crimson in color
and shaped like an oval. Blood enters it through the “hilus”
–an indentation on the bottom side of the organ–and travels
down vessels which grow steadily narrower and narrower.
This process not only traps the foreign bodies and debris that
clutter up the blood, it also helps to clear the body of cells
that are old and damaged. But this is just part of the wonder
that is the spleen: when we were all just embryos, our
spleens were already working overtime, producing the
white and red cells necessary to fuel our bodies. As we
leave the womb and grow into adulthood, the spleen
takes a less-vital role in our day-to-day existence, true,
but it’s still there, looking out for us. In fact, those suffering
from several anemia often receive a helpful infusion of fresh
red blood cells from their friendly spleen.

However, there are times when we must bid our spleen good-
bye. Those with spleen trauma, non-Hodgkin’s lymphoma,
hereditary spherocytosis, thalassemia, and Niemann-Pick
disease often choose to undergo a partial or full “splenectomy”,
or removal of the spleen. Don’t worry, though: modern
medical practice has evolved to the point where this is a
fairly safe procedure. Back in 1877, when only around 50
splenectomies had ever been attempted, roughly 70% of
those who opted for surgical removal of their spleen died
in the process. Today, with laproscopic technology and
high hygiene standards, the mortality rate for the pro-
cedure has fallen lower than 1%.

As heartening as this news is, let’s hope we can all keep our
spleens for as long as possible! Because, after all, is there
another reticuloendothelial organ that can store 100-300
milliliters of our blood? That’s 4% of the total amount that
the average human has! Is there another member of the
mononuclear phagocytic family that, historically, has been
considered the source of human melancholy, the cause of
rage, and the main reason why certain animals can’t run
as fast as other animals? No, of course not! Your spleen
is special: treat it as such.

(For this blog posting, I am indebted to two sources:
Schwartz’s Principles of Surgery–8th Edition, 2005 and
Taber’s Cyclopedic Medical Dictionary–20th Edition,
2005
. Please pick them up or steal them from your doctor’s
office for a profusion of fascinating facts, not only about the
spleen, but also about the liver, the esophagus, the cre-
master muscle, and the fallopian tubes...)