Splenomegaly


Splenomegaly

Description, Causes and Risk Factors:

Splenomegaly means enlargement of the spleen. The spleen is located on the left side of the abdomen. It can be considered as two organs in one, since it:

    Filters the blood and removes abnormal cells, such as old and defective red blood cells.

  • Produces disease-fighting components of the immune system, including antibodies and lymphocytes.

A normal spleen is 11 cm in length, 7 cm in width, and 4 cm in depth. The weight of the spleen varies greatly, a mean value of 150-170 g can be taken. The normal diameter of the splenic artery is 4-5 mm, while that of the splenic vein is 8-14 mm with a normal mean value of about 10 mm.

splenomegaly

Since the spleen is involved in so many bodily functions, it is vulnerable to a wide range of disorders. Some of the causes of splenomegaly include:

    Liver cirrhosis- which can increase the blood pressure inside the vessels of the spleen.

  • Cystic fibrosis - a genetic disorder, characterized by excessive mucus production, particularly in the lungs and pancreas.

  • Cytomegalovirus - a common viral infection that causes mild, flu-like symptoms.

  • Glandular fever - an infection caused by the Epstein-Barr virus [EBV].

  • Hemolytic anemias such as thalassemia, a genetic disorder that affects the production of the oxygen-carrying protein in red blood cells (hemoglobin).

  • Hodgkin's disease - cancer of the lymphatic system.

  • Leukemia - cancer of the bone marrow that affects the blood cells.

  • Lymphoma - cancer of the lymph nodes of the lymphatic system.

  • Malaria - a parasite transmitted to humans by the bite of infected mosquitoes.

Certain disorders, including glandular fever, can occasionally make the enlarged spleen delicate enough to rupture. A person with splenomegaly should take care to avoid all contact sports and any other activities that could potentially deliver a hard impact to their abdomen. An overzealous palpation of the abdomen or a sudden blow can split the outer capsule of the spleen and cause bleeding into the abdominal cavity. In this instance, surgery to remove the spleen (splenectomy) is needed. The body seems to cope without the spleen, despite this organ's many vital functions. However, the person may find they have an increased susceptibility to infection following the operation. Their blood may also contain odd-shaped red blood cells. In some cases, it may be possible to leave healthy portions of spleen intact, and only remove the diseased or damaged parts. This allows the spleen to keep performing its usual functions.

Prognosis depends on the underlying cause and progression of the disease. Left untreated, splenomegaly can lead to serious complications. Patients with splenomegaly need education with regard to decreasing their risk of splenic hemorrhage. These patients must be cautioned about contact sports and other activities that may acutely increase intra-abdominal pressure or place excessive forces on the left upper quadrant, left flank, or lateral back. This decreases the likelihood of splenic rupture in a patient with an abnormal splenic mass and capsule. The routine use of seat belts is essential while driving or riding in a motor vehicle.

Symptoms:

Symptoms may include abdominal pain, chest pain, chest pain similar to pleuritic pain when stomach, bladder or bowels are full, back pain, early satiety due to splenic encroachment, or the symptoms of anemia due to accompanying cytopenia.

Signs of splenomegaly may include a palpable left upper quadrant abdominal mass or splenic rub. It can be detected on physical examination by using Castell's sign or Traube's space.

Diagnosis:

Diagnosing splenomegaly involves a number of tests, including:

    Physical examination.

  • Blood tests, to check for underlying disorders.

  • Liver function tests (LFTs).

Imaging:

    Ultrasound or abdominal x-ray.

  • Computed tomography (CT) scan.

  • MRI scan.

Treatment:

Once the cause has been diagnosed differentially with great thoroughness, splenomegaly therapy is directed solely at the underlying disease - on the assumption that symptomatic and curative options are available. Radiation therapy and chemotherapy may be used to treat if any cancers, while regular blood transfusions are needed to manage thalassemia.

On occasion the spleen may need to be removed surgically as part of the disease treatment. For example, in hereditary spherocytosis, removing the spleen prevents the anemia that occurs when the abnormally shaped red blood cells are continually being filtered out and removed from the blood stream.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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