"Syndrome" in Greek means "congestion" or "connection." In medicine, this characteristic is given to diseases that have a certain number of recognizable features that often appear together. Thus, the totality of symptoms before an accurate diagnosis can be safely called a syndrome. One such condition is hepatolienal syndrome.
Characteristic
Hepatic-splenic syndrome is the second name for this condition. It is characterized by an increase in the liver and spleen, respectively, the work of these organs is disrupted. Hepatolienal syndrome occurs in chronic diseases of the hepatobiliary system and impaired blood circulation in the portal vein - splenic vein system.
Venous circulation in the liver and spleen gives an explanation of how these organs are connected and how they affect each other with such a deviation as hepatolienal syndrome. The venous connection of these organs can be traced.
The main vein is the portal. It collects blood from the spleen and other organs of the abdominal cavity. Then it enters the liver, where it is cleansed of harmful toxins and then carries nutrients throughout the body. The splenic part of the portal vein is, therefore, the spleen is in very close connection with the liver and the processes taking place in it. This explains why the liver and spleen are affected in hepatolienal syndrome.
Pathogenesis of hepatolienal syndrome
Violation of blood flow may occur due to narrowing of the lumen of the portal vein. There is stagnation of blood and, as a result, an increase in blood pressure. Why is this happening? Here are some reasons:
- External compression of the portal vein. This can occur both inside the liver and on the hepatoduodenal ligament at the entrance to the organ. In this case, it is possible to observe the symptoms of hepatolienal syndrome with such diseases:
- Cirrhosis of the liver.
- Severe hepatitis.
- Thrombosis of the portal vein and adjacent large veins.
- Primary tumor of the liver tissue.
- Cardiac pathology of the right half of the heart.
- Diseases of the bile ducts, tumors and cysts.
- Hepatic vein thrombosis.
2. The narrowing of the lumen of the veins:
- Thrombosis of the portal vein and its large branches.
- Hepatic vein thrombosis, or Budd-Chiari syndrome.
In addition to the damaging factors that can cause an increase in the liver and spleen, this can also occur as a protective reaction of the body to the ingestion of microbes.
Stages
There are several stages of hepatolienal syndrome:
- The first stage can take several years. The general condition is satisfactory, moderate anemia, leukopenia and neutropenia are observed. The liver is not enlarged, but it becomes much larger than the spleen.
- The second stage is characterized by a significant increase in the liver. There are signs of impaired functionality. May last several months.
- Third stage. Its duration is about one year. A decrease and hardening of the liver is characteristic, anemia is increasing, signs of hypertension, ascites, gastrointestinal bleeding, varicose veins of the esophagus appear.
- Fourth stage. General exhaustion, swelling, and bleeding symptoms are characteristic.
Causes of occurrence
Most often, hepatolienal syndrome occurs in children.
The causes in children and adults can be different:
- Inherited diseases.
- Infectious diseases.
- Congenital hemolytic anemia.
- Congenital and acquired diseases of the portal vein, spleen.
- Hemolytic disease in a newborn.
- Chronic alcoholism
Risk groups and their symptoms
All diseases that can provoke hepatolienal syndrome can be divided into groups:
- Acute and chronic liver diseases. This group is characterized by pain or a feeling of heaviness in the right hypochondrium, dyspeptic disorders, pruritus, jaundice. Causes may include viral hepatitis, contact with infectious patients, trauma or surgery, chronic alcoholism, hepatoxic drugs, acute abdominal pain, and fever.
- Diseases of accumulation. They are found among members of the same family or close relatives.
- Infectious and parasitic diseases. They are accompanied by a pronounced intoxication, fever, arthralgia and myalgia.
- Diseases of the cardiovascular system. They are accompanied by tachycardia, ischemic heart disease, fluid accumulation in the pericardial cavity, an increase and change in the configuration of the heart.
- Diseases of the blood and lymphoid tissue. This group is characterized by signs such as weakness, fever, swollen lymph nodes.
Symptomatology
If the patient has hepatolienal syndrome, the symptoms may be as follows:
- Enlarged liver and spleen. Pain on palpation.
- Weight loss.
- The work of the endocrine glands is disrupted.
- Problems in the digestive tract.
- Anemia. Paleness and dryness of the skin.
- Possible accumulation of fluid in the abdominal cavity.
- Muscle and joint pain.
- Yellowing of the protein coat of the eyes.
- Tachycardia, shortness of breath.
- Fragility of nails, hair loss.
To make a diagnosis, it is necessary to undergo an examination, and for a more detailed analysis of organs - a diagnosis.
Diagnostics
If the above symptoms occur, a differential diagnosis of hepatomegaly and hepatolienal syndrome is performed. To do this, you need to apply a range of activities. One of the first points is a general blood test and its biochemical study. To establish the reason for the occurrence of hepatolienal syndrome, differential diagnosis is simply necessary. In its framework is carried out:
- Sonography of the liver and spleen, gall bladder, vessels of the abdominal cavity.
- CT scan.
- Scanning of the liver and spleen.
- X-ray examination of the duodenum.
- Laparoscopy.
- Puncture biopsy of the liver and spleen.
- Examination of bone marrow and lymph nodes.
Currently, science does not stand still and the analysis of organs is constantly expanding in the diagnosis of a condition such as hepatolienal syndrome. Differential diagnosis underlying disease, taking into account the clinical picture and condition of the liver if available, is the main task.
Treatment and complications of the disease
As a rule, the treatment of hepatolienal syndrome is to identify the main pathological process and its treatment. It is not an independent disease. If you are diagnosed with Hepatolienal Syndrome, you should be treated by a gastroenterologist. In this case, hepatoprotectors, antiviral drugs, hormones and vitamins are used. In each case, there should be an individual approach, given the etiology of the disease.
If you miss the disease and do not treat it, the prognosis can be poor. Complications of this syndrome are liver cirrhosis, liver vein thrombosis, gallbladder inflammation, and blood diseases. In such cases, removal of liver and spleen segments or organ transplantation and blood transfusion is possible.
At the first stage, patients are able-bodied and can withstand small physical exertion. In the future, when the situation worsens, the patient becomes disabled.
Prevention
In order not to miss the beginning of the development of pathology, it is necessary:
- Take blood and urine tests regularly.
- Take timely examinations, especially if you are at risk.
- Prevention of hepatolienal syndrome primarily includes the fight against the causes of liver and spleen diseases.
- It is imperative to follow a proper diet so that the food contains the necessary amount of fats, proteins and carbohydrates and, of course, vitamins.
- Do not abuse alcohol, smoking and lead a healthy lifestyle.
There are no harmless diseases, especially if they relate to such vital organs as the liver and spleen. Timely detection of problems, and then adequate treatment can give effective results.