17180 Liver Spleen Scan

Overview

A liver and spleen scan is a painless imaging test. It takes pictures of two organs in your upper belly: your liver (which filters your blood and helps you digest food) and your spleen (a small organ that helps fight infection and cleans your blood). For this test, a tiny amount of a safe, slightly radioactive liquid is put into your arm through a small needle. The liver and spleen take up this liquid, and a special camera then takes pictures of them. The amount of radiation is very small and leaves your body within a day or so, mostly in your urine and stool.

Yes. Liver and spleen scans are routine tests done in hospitals all over the world every day. They are a normal part of checking how these organs are working.

Anyone can be asked to have this scan. It is most often done for adults who have belly pain, an enlarged liver or spleen, liver disease, or a known injury to the belly. Children sometimes have it too, usually with extra care taken to keep the radiation dose low.

Symptoms

Common symptoms

• Pain or a heavy, full feeling in the upper part of your belly, especially on the left or right side
• Feeling bloated or full very quickly when you eat
• Yellowing of the skin or the whites of your eyes (this is called jaundice)
• Feeling very tired or weak for no clear reason
• Bruising or bleeding more easily than usual
• Swelling in your legs or ankles
• Fever with belly pain and no clear cause

Symptoms in children

• A swollen or hard belly that a parent can see or feel
• Poor feeding, slower growth, or falling behind on the growth chart
• Yellowish skin or eyes
• Being more sleepy or fussy than usual
• Easy bruising or small pink or purple dots on the skin

Symptoms in older adults

• Tiredness or confusion that comes on slowly
• Belly swelling or discomfort that is easy to ignore
• Yellowing of the skin that a family member notices first
• Feeling full after only a few bites of food
• Swollen ankles or breathlessness

Causes

Main causes

• Your doctor wants to check the size, shape or position of your liver or spleen
• You have a liver condition, such as fatty liver, hepatitis (inflammation of the liver) or scarring of the liver
• You have an enlarged spleen, which can happen with some infections or blood conditions
• Your blood tests show unusual liver results and your doctor wants more detail
• You had an injury to your belly and the doctor needs to check for damage
• Your doctor wants to check how well the liver is working before or after surgery
• You are being checked after treatment for a liver or spleen problem

Risk factors

• Drinking a lot of alcohol over many years
• Being overweight or having type 2 diabetes, which can lead to fatty liver
• A blood infection or a long-term infection such as hepatitis B or hepatitis C
• Some inherited conditions that affect how the body stores iron or other substances
• Certain medicines that can affect the liver, especially when taken for a long time
• Contact with harmful chemicals at work or at home
• A family history of liver disease

When to see a doctor

See a doctor urgently if:

• You have severe or quickly worsening belly pain
• You are throwing up blood or have black, tar-like stools
• Your skin or eyes have turned yellow
• You feel confused, very sleepy, or unusually unsteady
• You have a fever with upper belly pain
• You have a scan booked but you feel much worse in the meantime

Book a routine appointment if:

• You have a scan letter and you are not sure what it involves, or how to prepare
• You take medicines and want to know whether to take them on the day
• You are pregnant, might be pregnant, or are breastfeeding
• You feel very anxious about the scan or the result
• You have had the scan and have not heard about the result within the time you were told

Diagnosis

There is nothing to diagnose on the day. The scan itself is the test. Your doctor orders it to get a clear picture of your liver and spleen, and then uses that picture, together with your symptoms and other tests, to decide what, if anything, needs to be done.

Tests that may be done

• Liver and spleen scan (the imaging test itself, using a tiny amount of a safe tracer)
• Blood tests to check how well your liver is working
• An ultrasound scan of the belly, which uses sound waves and no radiation
• A CT or MRI scan, which gives more detailed pictures
• Urine or stool tests, if infection or bleeding is suspected
• In some cases, a small sample of liver tissue (a biopsy) taken with a thin needle to look at under a microscope

What to expect at your appointment

You will usually be asked to arrive at the hospital's imaging or nuclear medicine department. A staff member will put a small needle into a vein in your arm and give you the tracer. This takes a minute or two. You then wait, often an hour or more, while the liver and spleen take up the tracer. You can usually sit and read or use your phone during this time. When it is time for the pictures, you lie on a flat bed while a camera moves above and below you. You need to lie still, but you can breathe normally. The pictures take about 30 to 60 minutes. The whole visit is often half a day. You can normally eat, drink and drive yourself home afterwards. A specialist doctor looks at the pictures and sends a report to the doctor who ordered your scan.

Treatment

A scan is not a treatment. It is a way of finding out what is going on so that you and your doctor can choose the right next step. Many people have a scan and need no treatment at all. If the scan does show something, your doctor will explain the options and talk them through with you.

Self-care at home

• Follow the instructions you are given about eating and drinking before the scan. These vary, so read your letter carefully or ring the department to check.
• Drink plenty of water afterwards to help your body clear the tracer.
• Go to the toilet as normal. Flush well and wash your hands afterwards for the rest of that day.
• Tell the staff if you are pregnant, might be pregnant, or are breastfeeding, before the tracer is given.
• Bring a list of all your medicines, including anything you buy without a prescription.
• Ask a friend or family member to come with you if you feel anxious, and to help pass the waiting time.
• Write down your questions before you go, so you do not forget them.

Medical treatments

What happens next depends entirely on what the scan shows. If it is normal, you may not need anything more. If it shows a liver or spleen problem, your doctor may suggest watching and re-checking over time, treating an underlying infection, helping you make changes to your diet and lifestyle, or referring you to a specialist. Some liver and spleen conditions are managed with medicines prescribed by your doctor, and others are managed mainly with lifestyle changes. There is no single treatment for everyone. Your doctor will explain the choices, the benefits and the possible side effects in a way that fits your situation.

When is surgery considered?

Surgery is only needed in a small number of cases. It might be discussed if the scan shows a growth that needs to be removed, damage to the liver or spleen after an injury, or a spleen that is causing serious problems. Most people who have a liver and spleen scan never need an operation. If surgery is ever suggested, your specialist team will explain why, what it involves, and what to expect afterwards.

Living with this condition

For most people, the scan is a single appointment and life carries on as normal straight away. You may feel a little tired after the visit, and some people find the waiting for results the hardest part. Try to keep to your usual routine, and plan something gentle and enjoyable for the day you expect your result.

Lifestyle tips

• Keep alcohol within the limits your doctor advises, or avoid it if you have been told to
• Eat regular meals with plenty of vegetables, fruit, beans and whole grains
• Stay active with something you enjoy, such as walking, swimming or cycling
• Aim for a healthy weight, losing a little at a time if that is a goal for you
• Get enough sleep, and tell your doctor if you feel very tired
• Ask your doctor or pharmacist to review your medicines, including supplements and herbal products
• Avoid contact with strong chemicals and always follow safety instructions at work

Diet and exercise

There is no special diet for having a scan. If you have a liver or spleen condition, a balanced diet with less processed food and less added sugar often helps. Gentle, regular movement is good for your liver and your mood. Build up slowly, and check with your doctor before starting anything strenuous if you have been unwell or have other health conditions.

Mental health and emotional wellbeing

It is very normal to feel worried before a scan or while you wait for the result. Many people feel nervous about the word 'radiation', about what the test might find, or about the hospital setting itself. These feelings usually settle, but if worry is affecting your sleep, your appetite or your day-to-day life, please tell your doctor. Talking therapies and other kinds of support are available and can really help. If you ever feel unable to cope or have thoughts of harming yourself, contact your local emergency number or a crisis line in your country straight away.

Prevention

You cannot prevent needing a scan. But you can lower your chance of liver and spleen problems, which are the reason most scans are done. Keeping alcohol within safe limits, staying at a healthy weight, eating well, moving regularly, and getting advice early about unusual symptoms all help protect these organs.

Vaccines

Some liver problems are caused by viruses that you can be vaccinated against. Ask your doctor or pharmacist whether you are up to date with hepatitis A and hepatitis B vaccines, and with routine vaccines in general. This is especially worth checking if you travel often, work in healthcare, or have a liver condition.

Screening programmes

There is no general screening programme for liver and spleen problems in most countries. If you have risk factors such as a long history of heavy drinking, fatty liver, type 2 diabetes, or a family history of liver disease, ask your doctor whether blood tests or a scan would be worthwhile for you.

Complications

If left untreated

• A liver or spleen problem that is not checked can slowly get worse without you noticing
• Ongoing liver damage can lead to scarring, which may affect how well the liver works
• Some liver conditions can cause a build-up of fluid in the belly or swelling in the legs
• An enlarged spleen can sometimes hold on to too many blood cells, causing tiredness or easy bruising
• Rarely, serious liver problems can cause confusion or bleeding that needs urgent care

Long-term outlook

The outlook is good for most people. Many scans come back normal, and many problems that are found are manageable, especially when they are picked up early. A scan is simply a way of getting clear answers so that you and your doctor can act on them. Whatever your result, your healthcare team will be there to explain it and to plan the next step with you.

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