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The spleen, the strange little organ that can multiply

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Re: The spleen, the strange little organ that can multiply

#21

Post by JshWright »

shakna wrote: post #19
JshWright wrote: post #18

Earlier quoted context omitted.

The spleen is a solid organ. Imagine squeezing a solid ball made of foam or gelatin. It will tear as you squeeze it, as it can't flatten out like a hollow sphere could (i.e. your stomach, intestines, etc). You have a number of solid organs, but the spleen and the liver are the most commonly injured, due to their positions on opposite sides of your abdomen. Splenic ruptures are fairly common with serious abdominal tra…

How common without serious abdominal trauma? I didn't bruise, tear any muscles or crack any ribs or anything of the like. That kind of stat might give me something to brag about, not like a crappy immune system is something to be proud of. The grading system is kinda cool. Unfortunately I can't use behind my current WiFi away from home. Maybe you can tell me how I did: The spleen was horizontally rupture into two pie…

It's not that uncommon to have little to no bruising. One of the more common signs is actually pain in the left shoulder[1]

As far as the grading of your spleen... It depends on whether the major vessels leading into the spleen were torn or not, but it certainly sounds like you had a grade 4 or 5 tear (on a scale of 1 to 5).

[1]: https://en.wikipedia.org/wiki/Kehr's_sign

Re: The spleen, the strange little organ that can multiply

#22

Post by shakna »

JshWright wrote: post #21
shakna wrote: post #19

Earlier quoted context omitted.

How common without serious abdominal trauma? I didn't bruise, tear any muscles or crack any ribs or anything of the like. That kind of stat might give me something to brag about, not like a crappy immune system is something to be proud of. The grading system is kinda cool. Unfortunately I can't use behind my current WiFi away from home. Maybe you can tell me how I did: The spleen was horizontally rupture into two pie…

It's not that uncommon to have little to no bruising. One of the more common signs is actually pain in the left shoulder[1] As far as the grading of your spleen... It depends on whether the major vessels leading into the spleen were torn or not, but it certainly sounds like you had a grade 4 or 5 tear (on a scale of 1 to 5). [1]: https://en.wikipedia.org/wiki/Kehr's_sign

That's really interesting, aren't nerves wonderful things?

4 or 5 sounds about right, I lost something around 2 quarts of blood, though that may have more been due to inaction.

All I remember from the ultrasound was thinking the red was really pretty, and then vomiting.

Thanks for sharing your knowledge, it's fascinating stuff.

Re: The spleen, the strange little organ that can multiply

#23

Post by rajuvegesna »

Nothing was mentioned about multiple spleens at birth (Polysplenia). Yes, some people are born with multiple spleens. In such case, it has nothing to do with injury and there doesn't seem to be enough knowledge on why this occurs.

Multiple spleens often result in mis-diagnosis (during radiology) leading to wrong treatment. When you know you have accessory spleens, it is always good to give them a heads up.

Re: The spleen, the strange little organ that can multiply

#24

Post by dang »

stcredzero wrote: post #4

A housemate of mine used to call herself "The spleenless wonder." It was removed after a car accident.

> The spleenless wonder

For those who might not recognize it, this derives from a hilarious (and, atypically, authenticated) witticism of Churchill's: http://www.newsweek.com/boneless-wonder-176272.

Had my kids been in Parliament in 1931 they would have said "burn".

Re: The spleen, the strange little organ that can multiply

#25

Post by JshWright »

shakna wrote: post #22
JshWright wrote: post #21

Earlier quoted context omitted.

It's not that uncommon to have little to no bruising. One of the more common signs is actually pain in the left shoulder[1] As far as the grading of your spleen... It depends on whether the major vessels leading into the spleen were torn or not, but it certainly sounds like you had a grade 4 or 5 tear (on a scale of 1 to 5). [1]: https://en.wikipedia.org/wiki/Kehr's_sign

That's really interesting, aren't nerves wonderful things? 4 or 5 sounds about right, I lost something around 2 quarts of blood, though that may have more been due to inaction. All I remember from the ultrasound was thinking the red was really pretty, and then vomiting. Thanks for sharing your knowledge, it's fascinating stuff.

Two quarts is getting very close to irreversible shock territory, so nice job not dying.

EDIT: Upon rereading... If you were in primary school, then two quarts would represent a very large fraction of your total blood volume (like, anywhere from 70 to 120%). You'd be very firmly in 'dead' territory at that point (assuming they weren't simultaneously putting more in)

Re: The spleen, the strange little organ that can multiply

#26

Post by [deleted] »

shakna wrote: post #22
JshWright wrote: post #21

Earlier quoted context omitted.

It's not that uncommon to have little to no bruising. One of the more common signs is actually pain in the left shoulder[1] As far as the grading of your spleen... It depends on whether the major vessels leading into the spleen were torn or not, but it certainly sounds like you had a grade 4 or 5 tear (on a scale of 1 to 5). [1]: https://en.wikipedia.org/wiki/Kehr's_sign

That's really interesting, aren't nerves wonderful things? 4 or 5 sounds about right, I lost something around 2 quarts of blood, though that may have more been due to inaction. All I remember from the ultrasound was thinking the red was really pretty, and then vomiting. Thanks for sharing your knowledge, it's fascinating stuff.

[deleted]

Re: The spleen, the strange little organ that can multiply

#27

Post by Asparagirl »

Oh hey, this is me! I had two accessory spleens. But the bad news is that ALL of them absolutely had to come out -- the accessories were discovered during a medically necessary splenectomy.

As the article says, the spleen filters your red blood cells and platelets. Think of it like a swimming pool filter for your blood stream. It knows which cells to break down because they're misshapen, spherical, instead of the "donut without a hole" shape. RBC's live about three months before degrading like that.

There's just one problem: what happens if your red blood cells are ALL funny-shaped, even the young healthy ones? Why then, your spleen valiantly tries to catch 'em all, like Pokémon, and you end up breaking down your own blood supply, auto-hemolytic anemia.

Welcome to hereditary spherocytosis, which is what I have. Despite its name, it was not hereditary in my case; about 25% of cases are de novo mutations. Incidence is about 1 in 6500, though some milder cases go undetected.

So, after a childhood of jaundice at birth, inexplicable anemia, paleness, and just being really really tired all the time, finally at age six did my pediatrician notice that my spleen was massively enlarged (due to working overtime) and two years later I had to have it out, along with the two accessories they discovered on the operating table. This was the late 1980's so I juuust missed the beginning of the era of laparoscopic surgery, so I have a heck of an abdominal scar.

Poor little spleen, it was only trying to do its job. The fault lay with my blood, not with it.

Meanwhile, I'm immune-compromised for life and have to stay on top of all kinds of vaccines. Note to other spleenless wonders posting here: there's a brand new Meningitis Type B vaccine that just came out in late 2014; get on that. Also Prevnar, Pneumovax, annual flu shots and all the other fun stuff.

Re: The spleen, the strange little organ that can multiply

#28

Post by berntb »

berntb wrote: post #9
stcredzero wrote: post #4

A housemate of mine used to call herself "The spleenless wonder." It was removed after a car accident.

I got just one extra spleen (small, one percent of the population or so have that. Edit: at least that was what the doctor told me; TFA said 20%). I call myself "splenically superior" and argue that it obviously explains my mean personality. :-)

HN used to downvote stupid jokes like mine in the previous comment, not upvote them.

I humbly submit that I deserved downvotes. It is better to disincentive us hopeless clowns on HN, even when we manage to be funny.

Edit: That was quick. :-)

Re: The spleen, the strange little organ that can multiply

#29

Post by kahrkunne »

Asparagirl wrote: post #27

Oh hey, this is me! I had two accessory spleens. But the bad news is that ALL of them absolutely had to come out -- the accessories were discovered during a medically necessary splenectomy. As the article says, the spleen filters your red blood cells and platelets. Think of it like a swimming pool filter for your blood stream. It knows which cells to break down because they're misshapen, spherical, instead of the "do…

>finally at age six did my pediatrician notice that my spleen was massively enlarged (due to working overtime)

Who was working overtime here? Six year old you or the pediatrician? Neither makes sense to me.

Re: The spleen, the strange little organ that can multiply

#30

Post by heimdall »

kahrkunne wrote: post #29
Asparagirl wrote: post #27

Oh hey, this is me! I had two accessory spleens. But the bad news is that ALL of them absolutely had to come out -- the accessories were discovered during a medically necessary splenectomy. As the article says, the spleen filters your red blood cells and platelets. Think of it like a swimming pool filter for your blood stream. It knows which cells to break down because they're misshapen, spherical, instead of the "do…

>finally at age six did my pediatrician notice that my spleen was massively enlarged (due to working overtime) Who was working overtime here? Six year old you or the pediatrician? Neither makes sense to me.

The spleen was the one working overtime, since it would normally be filtering a fraction of his blood that was problematic, but instead 100% of his blood 'needed' to be filtered.
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