Symptoms An enlarged spleen doesn't cause many symptoms, and none of them reveals the specific cause of enlargement. Because the enlarged spleen lies next to the stomach and may press against it, a person may feel full after eating a small snack or even without eating. Diagnosis Usually, a doctor can feel an enlarged spleen during a physical examination. An x-ray of the abdomen may also show that the spleen is enlarged. Other specialized scanning devices use mildly radioactive particles to assess the spleen's size and function and to determine whether it is accumulating or destroying large numbers of blood cells.
Blood tests show decreased numbers of red blood cells, white blood cells, and platelets.
When blood cells are examined under a microscope, their shape and size may provide clues to the cause of the spleen enlargement. These disorders can cause an enlarged spleen. Blood protein measurement can help rule out such conditions as multiple myeloma, amyloidosis, malaria, kala-azar, brucellosis, tuberculosis, and sarcoidosis. Liver function tests help determine whether the liver is damaged along with the spleen. When possible, a doctor treats the underlying disease that caused the enlarged spleen.