Daniel BuenoSometimes, in the middle of a race, a sharp pain in the left of the abdomen obliges the runner to slow down. Though this is often called a “pain in the spleen,” it is actually a diaphragm spasm. This muscle and the spleen are connected by a ligament that can cause pain when stretched. Generally, just reducing effort intensity causes the pain to disappear. The spleen’s main functions are to remove old red blood cells and platelets from circulation, to store the iron obtained from the red blood cells and to produce antibodies. In the case of severe trauma, and among some people with rare hemorrhagic or coagulation diseases such as hemolytic anemia or thrombocytopenic purpura, it may be necessary to extract the spleen. Usually, this does not jeopardize the person´s quality of life. When the spleen is removed, other organs take over its activities. The liver removes the old red blood cells from the blood and the bone marrow takes charge of most of the production of antibodies. The spleen is more important during childhood, while the immune system and immunological reactivity are maturing. Even earlier, in the fetus, the spleen is one of the main producers of blood cells (both white and red). Recent research, however, shows that people who have had their spleen removed are at a higher risk of developing sepsis when they are infected by bacteria such as pneumococci, meningococci and hemophiles. Therefore, physicians now avoid full extraction of the organ. At least a portion of it is left in place, even in the cause of accident-induced trauma.
Ana Maria Caetano de Faria, Federal University of Minas Gerais (UFMG)
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