The liver and spleen are closely interconnected by the system of the collar vein and have common pathways of lymph flow and innervation. If a problem arises in one organ, it inevitably affects another. Hepatosplenomegaly is an increase in the liver and spleen that occurs simultaneously.
Diagnostics
Diagnosis of this syndrome is based on patient complaints. It matters age, the time when pain or discomfort occurred, causes, hereditary factors.
Then the doctor conducts examination by percussion and palpation. Hepatosplenomegaly can be detected by visual examination. It looks like a swelling under the right hypochondrium, which shifts when you inhale.
To clarify the diagnosis, laboratory diagnostics are necessary, which reveals the functional state of the liver. For this, various tests are carried out, such as checking the level of ceruloplasmin, serum iron and other indicators.
An echoscope is used as an instrumental examination , and then computed tomography is prescribed. But the most accurate size of the liver can be detected only by angiography, it also allows you to determine the nature of the lesion and identify possible obstacles to blood flow.
Causes
Hepatosplenomegaly is a syndrome that develops with a number of diseases. An enlargement of the liver and spleen is not a concern in itself, although this is what most worries the patient. No matter how dangerous hepatosplenomegaly may seem, the causes should be clarified first. The efficiency and effectiveness of treatment depends on this. All reasons can be divided into five groups:
- Acute liver diseases in which blood circulation in the portal vein system is disturbed. These include hepatitis, cirrhosis, vascular lesions.
- Chronic infections and parasitic infections. These are malaria, infectious mononucleosis, syphilis, leishmaniasis, brucellosis and others.
- The third group includes metabolic diseases - hemochromatosis, amyloidosis.
- The fourth group includes systemic blood diseases - anemia, leukemia, lymphogranulomatosis.
- The fifth group includes diseases of the cardiovascular system with the development of chronic heart failure: hypertension, congenital and acquired heart defects, coronary heart disease.
Hepatosplenomegaly in children
Hepatosplenomegaly in a child can occur at any age, including in a newborn. The increase, as in adults, is determined by palpation. Usually, hepatosplenomegaly in young children is accompanied by jaundice, anemia, and fever. For a correct diagnosis, it is first necessary to determine the nature of jaundice (hemolytic or parenchymal). This will allow you to develop the right treatment tactics.
In the first hours of life, hepatosplenomegaly in combination with jaundice is often the result of intrauterine infection with tuberculosis or syphilis. Often, hepatosplenomegaly becomes a consequence of congenital hepatitis or cirrhosis. In this case, the surface of the liver is uneven, the consistency is solid. A strong increase in very young children is observed with anomalies of the biliary tract. In this case, jaundice grows quite quickly, accompanied by melena, umbilical bleeding. Signs of biliary cirrhosis of the liver with portal hypertension quickly appear.
In older children, a simultaneous increase in the liver and spleen may be associated not with a viral or bacterial infection, but with an elementary violation of proper nutrition. Fatty foods rich in carcinogens are a serious burden on the internal organs. The first blow is taken by the liver, which acts as a filter in the body. As a result, having failed to cope with a large number of harmful components, the liver grows in size and entails changes in the spleen.
Treatment
After a thorough examination and clarification of the causes, the underlying disease is treated. Hepatosplenomegaly is not a disease, but a syndrome. Special or universal treatment is not required. Cholespasmolytics (Papaverine, No-shpa, Platifillin medicines), choleretic drugs (Holosas, Xylitol), hepatoprotectors (Silibor, Essentiale, Heptral medicines are prescribed as maintenance therapy for the liver). "," Carsil "," Riboxin and others). In parallel, hormone therapy is underway, such as Prednisolone and multivitamin complexes.
When a phenomenon such as hepatosplenomegaly occurs, treatment is accompanied by a mandatory normalization of the intestinal biocenosis. Doctors may prescribe drugs containing lacto and colibacteria, such as Linex, Primadofilus, Bifiform, Hilak-forte and others.
Diet
Fatty foods, preservatives, dyes, and carcinogens found in many foods adversely affect the liver, stomach, and spleen. To help the internal organs defeat the disease, it is important to maintain a strict diet at least for the duration of treatment. The diet should consist of dietary, low-fat and fresh food. There should not be any sausages, chips, yoghurts for long-term storage. The basis of the diet is dietary soups, cereals without butter, low-fat cottage cheese. Tea, coffee, and long- life juices are replaced with plain mineral water, homemade compotes, and kissels. Cakes, pastries and other fatty desserts are also contraindicated. It’s better to give up sweets altogether or limit yourself to green tea with honey and crackers. Hepatosplenomegaly is a phenomenon that can be eliminated only with the joint efforts of a doctor and a patient.