Mumbai: A Bhayandar-based man, who went through a splenectomy after 17 years of struggling with pain due to an enlarged spleen, was surprised to find out that he can hold a world record for the largest spleen. The spleen removed from the body of the 38-year-old patient had grown to 90 cm and weighed 8.5 kg, which had taken over the entire abdomen.
Spleen is an accessory organ in the human body behind the stomach and under the diaphragm which primarily filters blood and also works as immune support to the body. A standard size of a spleen is 13 cm long, 7.5 cm wide and 3.8 cm thick which weighs around 170 gm. However, the doctors at Mira Road’s Wockhardt Hospital were shocked when a patient who had come with complaints for abdominal pain and swelling had a 90 cm long spleen in his abdomen, weighing around 8.5 kg.
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Rajkumar Tiwari was suffering from splenomegaly and hypersplenism, where the spleen kills blood cells prematurely resulting to severe pancytopenia, where his haemoglobin had dropped down to almost half the normal requirement, white blood cells were reduced by almost four times the required amount and platelets were as much as negligible. The massive splenomegaly was damaging Tiwari’s liver causing jaundice and had put him into a life threatening situation.
The team of doctors led by Dr. Imran Shaikh, Consultant GI and HPB Surgeon, decided to carry out a splenectomy to remove the spleen from the patient’s body. The patient was not being optimised in spite of undergoing multiple blood transfusions as the spleen was eating up platelets and other blood cells, which had increased the risk of massive bleeding during the surgery. However, the team of doctors stopped the blood supply to the spleen throughout the night and operated on the patient in the morning when his haemoglobin, WBC and platelets increased to normal requirement.
Dr. Shaikh said, “With a very low platelet count, surgery was extremely risky with life-threatening bleeding. The patient was planned for abdominal angiography and embolization of the splenic artery. In this procedure, we blocked the main blood supply to the spleen by putting coils in the artery to avoid the killing of transfused blood products. Post-coiling embolization, we transfused blood products to carry out surgery and increase the safety margin for patients.”
After a six-hour long surgery, the spleen was removed from the patient’s body, which was adherent to the intestines, pancreas,diaphragm, and stomach. It was 90 cm long, 45 cm wide and 17 cm thick. The doctors claimed that the 8.5 kg spleen is the biggest spleen recorded across the world until now as the last biggest spleen was recorded in the USA in 2020, which was 73.66 cm long and weighed 2.3 kg. The post surgery histopathology report said that the patient was suffering from splenic histiocytosis, which is a rare disorder of the massive enlargement of spleen and can become life threatening.
Tiwari said, “I used to get black patches throughout my body and it would disappear within 24 hours. The doctors found that it was happening because of very low platelets but couldn’t trace the root cause. However, after 17 long years of struggling with an enlarged spleen, the weight has been lifted off my shoulders as I underwent surgery to have it removed and have completely recovered within 1.5 months.”
Dr. Shaikh also added that the spleen is a vital organ for kids and after 12 years of age, its function is taken over by bone marrow and liver. Therefore, an adult person can live a normal life without the accessory organ.
