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Splenomegaly, what is it? - Causes, symptoms and treatment

The spleen is a fist-sized organ located on the left under the rib cage. Due to various diseases, it can increase in size - this phenomenon is called splenomegaly. What is it, how to treat this violation - we describe in detail in this publication.

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Splenomegaly - what is it?

Splenomegaly is an enlargement of the spleen. Pathology can be caused by many causes and is found in both adults and children. The spleen plays an important role in fighting infections. Leukocytes are formed in it, which are the first to begin the destruction of pathogens that have entered the body.

Splenomegaly Other functions of the spleen:

  1. Filtration and destruction of damaged and old blood cells;
  2. The production of reserve red blood cells, which are used by the body when necessary, for example, for blood loss;
  3. Protein synthesis;
  4. Storage of blood cells (platelets, red blood cells, white blood cells);
  5. Destruction of insoluble compounds caused by burns.

Splenomegaly is considered as a symptom of a disease and is accompanied by a violation of each of these important processes. For example, the spleen begins to filter out not only damaged, but also normal blood cells, which accumulate in it, interfere with the proper operation of the organ.

Causes of splenomegaly

There are many diseases that cause splenomegaly. This phenomenon may be temporary, which depends on the effectiveness of the treatment of the underlying disease. In addition to the pathologies of the spleen — tumors, cysts, organ infarctions, abscesses — with splenomegaly, the reasons may be as follows:

  • acute and chronic bacterial infections - sepsis , tuberculosis , syphilis , brucellosis;
  • viral pathologies - hepatitis, rubella, measles;
  • mycoses - blastomycosis, histoplasmosis and other fungal infections of the blood and internal organs;
  • protozoal infections - leishmaniasis, malaria , toxoplasmosis ;
  • helminthiasis - echinococcosis , schistosomiasis;
  • circulatory disorders - the development of portal hypertension , Pick's cirrhosis;
  • systemic diseases of the blood-forming organs - leukemia, lymphoma, myelofibrosis;
  • pathologies associated with metabolic disorders - glycogenosis, Wilson's disease;
  • autoimmune diseases in which the immune system takes the cells of the body for alien - rheumatoid arthritis, systemic lupus erythematosus.

The cause of the development of splenomegaly is also anemia of different types - pernicious, hemolytic, and others.

Splenomegaly in children

In childhood, the spleen is sometimes slightly enlarged without any disturbances in the child’s body. This is a physiological norm and is observed in a third of newborns, in 15% of half-year-old children, and in a small proportion of younger students.

The norms of the maximum size of the spleen in children are presented in the table:

Age years 1 2 3 4 5 6 7
Width / length, mm 65/25 72/34 79/37 84/39 88/39 91/41 96/41
8 9 10 eleven 12 13 14 15 16
100/43 102/43 103/44 108/44 113/45 118/46 120/48 120/49 121/51

Splenomegaly in children is a symptom of the same diseases as in adults, there is no difference.

There are two forms of splenomegaly:

  1. Inflammatory, resulting from inflammation of the tissues of the organ (bacterial, protozoal, viral infections, worm infestations, abscesses and heart attack);
  2. Non-inflammatory, due to disorders not associated with infections and inflammations (with anemia, systemic, autoimmune diseases).

Also, moderate splenomegaly is isolated when the length of the spleen does not exceed 20 cm, and heavy - 21 cm or more.

Symptoms of splenomegaly in children and adults

Symptoms of splenomegaly in children and adults

pain on the left under the ribs - one of the symptoms, photo

Since the enlargement of the spleen is a manifestation of a disease, it does not have any general symptoms. There are only signs of splenomegaly associated with its two forms.

1 - manifestations at inflammations:

  • high temperature, up to 40 ° C;
  • sharp cutting pain in left hypochondrium;
  • mild nausea;
  • sometimes vomiting and diarrhea;
  • palpation of the left side under the ribs.

2 - symptoms of splenomegaly without inflammation:

  • pulling, aching, unexpressed pain in left hypochondrium ;
  • body temperature remains normal, and if it rises, then to a maximum of 37.5 ° C;
  • when palpating the side, the pain is not strong.

Diagnosis of splenomegaly

Primary diagnosis of splenomegaly is carried out by palpation of the abdomen in the left hypochondrium. To clarify the diagnosis shown such studies:

  • General blood count to detect the number of white blood cells, red blood cells and platelets;
  • Taking liver samples;
  • MRI and computed tomography;
  • ultrasound examination;
  • A bone marrow biopsy that gives more complete information about the state of the blood cells.

Puncture biopsy of the spleen is extremely rare, since it carries the risk of bleeding.

Tactics of treatment of splenomegaly

Therapy of splenomegaly in adults and children is to identify and eliminate the pathology that provoked an increase in this organ. Depending on the specific disease, the following drugs are prescribed:

  1. Antibiotics - for bacterial infections;
  2. Antiviral agents;
  3. Antiparasitic drugs to combat helminth infections;
  4. Hormonal drugs with immunosuppressive and anti-inflammatory effects - with autoimmune pathologies;
  5. Antineoplastic drugs;
  6. Antifungal agents for the treatment of mycoses;
  7. Vitamins - with beriberi, combined with anemia.

Removal of an enlarged spleen by surgery (splenectomy) is indicated if a conservative treatment of splenomegaly does not work.

Surgical intervention is also necessary for:

  • hypersplenism, when healthy blood cells are destroyed in the spleen;
  • thrombocytopenic purpura;
  • Banti syndrome;
  • hemolytic jaundice.

The operation is often carried out through laparoscopy - through small incisions. As a result of spleen removal, the body’s ability to resist infections is reduced. In this regard, antibiotics are required before and after splenectomy. Vaccination against meningitis, hemophilic, pneumococcal infection and influenza is also carried out.

Complications

Possible complications of splenomegaly include:

  • Hypersplenism - a deficiency in the blood of the formed elements due to their disintegration in the spleen (leukopenia, anemia, thrombocytopenia);
  • Organ rupture;
  • The aggravation of the pathology, against which the spleen was enlarged.

Splenomegaly - which doctor to contact?

Since the spleen belongs to the blood-forming organs, the hematologist deals with the treatment of its pathologies. But since the pain in the left side under the ribs and other manifestations of splenomegaly can be the result of various diseases, first you should make an appointment with the therapist, describing in detail all the symptoms to him.

After examining and examining the results of the main tests, he will refer to a narrower specialist for further diagnosis and treatment.

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