Splenomegaly - what is it? You will get the answer to the question below. In addition, we will talk about why such a disease occurs, what are its symptoms, the processes of its diagnosis and treatment.
General information
Splenomegaly - what is it? In medical practice, this term is called a disease, which is characterized by a significant increase in the spleen. As a rule, this happens when the presented organ is involved in pathological processes from the side. However, it should be noted that the mass of the spleen even in the normal state can be much larger (2 times) than any other organ. That is why the established threshold from which an increase in this organ is considered splenomegaly is always conditional. So, in a normal state, the mass of the spleen in an adult is about 100-150 g. On palpation, a healthy organ should not exceed 7 centimeters (diagonally). The diagnosis of splenomegaly of the spleen is quite rare. This happens under the following conditions:
- if the size of the organ exceeds the mentioned value;
- if splenic dullness is abnormally intense;
- if the spleen is clearly palpated.
The role of the spleen in the human body
Splenomegaly - what is it? We examined the answer to the question above. The spleen is an essential organ of the immune system. As you know, it has a bean-shaped shape and is located in the upper left part of the abdominal cavity, or rather, under the diaphragm. In this case, the spleen is bent between the 9th and 11th ribs. In a healthy adult, the organ presented weighs about 150 grams. It covers an area in the abdominal cavity measuring approximately 11 centimeters vertically.
Spleen functions
The presented organ plays a crucial role in the human body. His job is to exclude foreign organisms or bacteria from the blood circulation, as well as develop antibodies for the immune system and remove abnormal blood cells.
It should be specially noted that the spleen can increase in size even when it performs its usual functions, in response to a disease. This is due to the fact that some infections that affect blood cells can increase blood flow in this organ. According to experts, diseases that affect the spleen quite often are the causes of its large size. However, the diagnosis of splenomegaly is rare. After all, an increase in this organ does not always indicate its abnormal condition.
Pathological dimensions of the spleen
Splenomegaly - what is it? This diagnosis is made with an abnormally enlarged spleen. In this case, the presented organ can weigh about 500 grams, and its largest size can vary from 11 to 20 centimeters. Splenomegaly, the causes of which we will discuss below, accompanied by an organ weight of more than 1000 grams and a length of more than 20 centimeters, is considered massive or severe. To treat such a pathology, the patient may need complex therapy or even surgical intervention.
Splenomegaly: causes of the disease
There are many reasons for the occurrence of such a pathological condition. They are diverse and often range from malignant tumors (cancer), congestion (or a strong increase in blood flow), infections and organ infiltration by other diseases to inflammatory diseases and ailments of blood cells.
Consider the most common causes of enlarged spleen, which include factors such as:
- blood cancer (e.g., leukemia, lymphoma, or myelofibrosis);
- blood cell diseases (e.g., spherocytosis, thalassemia, or sickle cell anemia);
- liver diseases (e.g., chronic hepatitis C, cirrhosis due to chronic hepatitis B, prolonged use of alcoholic beverages, and fatty liver) ;
- inflammatory diseases (rheumatoid arthritis and lupus erythematosus);
- Gaucher disease (or ailment of lipid metabolism);
- abnormal blood flow and blockage of blood vessels, veins (for example, spleen vein thrombosis, congestive heart failure and blockage of the portal vein);
- thrombocytopenic idiopathic purpura;
- various infections (bacterial endocarditis, mononucleosis, AIDS, malaria, Leishmania, mycobacteria, etc.).
Splenomegaly: symptoms of the disease
As you know, such a deviation as splenomegaly does not have specific symptoms. However, the most common among them are fuzzy pain in the abdominal cavity and bloating. All of the listed signs of splenomegaly are considered non-specific. It should be noted that some people with a greatly enlarged spleen quite often complain of rapid satiety and symptoms of gastric reflux.
The last symptom of the disease occurs due to the fact that due to pressure on the abdominal cavity, the stomach begins to move.
In other cases, the symptoms that are associated with an increase in this organ include the following:
- night sweats;
- fever
- weight loss
- general weakness;
- pallor;
- slight bruising;
- fatigue.
When and to whom to seek medical help?
Splenomegaly in children and adults requires mandatory observation by an experienced doctor. However, not every person who has such a pathological condition knows which doctor he should contact. In this regard, it should be noted that the choice of a specialist depends, first of all, on what contributed to the development of this disease. Thus, patients can consult a hematologist (a doctor who specializes in the treatment of blood diseases), an oncologist (a specialist in cancerous tumors) and a gastroenterologist (a specialist in diseases of the gastrointestinal tract, including the liver). After going to the doctor, the latter should conduct a full medical examination, and then prescribe an effective treatment.
Depending on the cause of the disease, people with this diagnosis may need urgent hospitalization. This usually happens if patients have unbearable abdominal pain, as well as bleeding symptoms and infections that cannot be treated at home.
Inspection
After contacting a specialist, the patient is primarily expected to be examined. For this, doctors use palpation and percussion methods. Using such methods, they determine the size of the spleen. In the normal state, about 3% of people have an easily palpable organ. However, the palpable mass in the upper left abdominal cavity may be due to a completely different cause, rather than an enlarged spleen. That is why specialists use other diagnostic methods.
If splenomegaly during palpation was not detected, but all the symptoms indicate its presence, a general blood test can be prescribed to the patient. During this study, experts evaluate the composition, shape and number of white blood cells, platelets and red blood cells. These indicators can also refute or confirm the presence of the disease.
Diagnosis of splenomegaly
If, after examining and passing a number of analyzes, experts doubt the results, then for a more accurate diagnosis, an ultrasound examination is performed, as well as computed and magnetic resonance imaging. These methods are able to provide a detailed image of the internal organs, and therefore, with high accuracy to determine the presence or absence of a disease. It should also be noted that magnetic resonance imaging is especially effective during the determination of splenic vein thrombosis or portal thrombosis.
Among all others, a radioisotope study is used to diagnose such a disease. This is a highly accurate method that is able to clearly identify details of spleen tissue. However, the presented method is not easy to perform and very expensive.
Types of disease
Depending on the causes of this pathological condition, its treatment may be different. It should be especially noted that today very often patients talk about such a diagnosis as "splenomegaly of the liver." Although this term is not entirely correct, in reality, an enlargement of the spleen is often accompanied by an increase in other internal organs. Such a picture can significantly worsen the condition of the patient and his treatment.
- Moderate splenomegaly - what is it? This is an increase in the spleen, which arose as a result of any pathological phenomena from the side.
- Hepatomegaly is a kind of enlargement of the liver, which is combined with an increase in the above organ.
- Hepatolienal syndrome is a simultaneous increase in both the spleen and liver.
Disease treatment
What to do if the patient is diagnosed with splenomegaly? Treatment of this organ should be directed to the primary cause of the ailment. After all, as you know, such a disease is only a manifestation of another pathology. It is also worth noting that there is no need to treat an enlarged spleen until severe hypersplenism develops in the patient's body.
Often, in parallel with the therapy of the underlying disease, specialists carry out a number of measures to improve the patient's condition and treat splenomegaly. These procedures include the following:
- leukocyte transfusion;
- platelet transfusion;
- treatment of the patient with glucocorticoids (in this case, the drug "Prednisolone" is prescribed in an amount of 20-40 milligrams per day for 4-6 months);
- removal of an enlarged organ or splenectomy.
Surgical intervention
Splenectomy is performed by specialists quite rarely. As a rule, such an operation is aimed at combating the underlying disease. Splenectomy is usually performed in conditions such as thalassemia, blockage of the splenic veins, Gaucher disease, and leukemia. The decision to remove the enlarged spleen is made by the doctor individually for each patient. It depends on the state of affairs and the likely risk to the life of the patient. Indeed, with severe damage to the organ, a rupture of the spleen can occur, which will entail internal hemorrhage. By the way, precisely for this reason, patients who are diagnosed with splenomegaly are strictly forbidden to engage in sports and any physical labor.
What threatens the removal of the spleen?
The absence of this organ, or the so-called asplenia, carries a rather increased risk of infection of the body with some life-threatening viruses, which include the following: Neisseria meningitidis, Hemophilus influenzae and Streptococcus pneumoniae. That is why, after splenectomy, it is imperative to vaccinate against all of the bacteria listed.
Recovery
Splenomegaly itself is incurable. After all, it is only a reaction of the spleen to any other pathologies in the human body. With anemia, the patient is prescribed iron and arsenic. If this deviation is accompanied by thrombopenia and leukopenia, then doctors remove the inflamed organ. It should be especially noted that after the operation, the patient immediately noted an increase in the number of platelets and leukocytes, the signs of hemorrhagic diathesis disappear, the patient significantly increases in weight and his general condition improves. If a teenager with such a diagnosis had growth retardation, then after splenectomy everything returns to normal. If by the time of the operation the patient had no exhaustion of the body, and also changes in the organs and bones were not observed, then he quickly begins a remission.
To summarize
In general, a diagnosis such as splenomegaly is not as dangerous as its underlying disease. It should be especially noted that in modern medical practice there have been many cases where even a greatly enlarged spleen returned to its normal size after conducting combination therapy of the underlying disease. This is partly due to the fact that existing diagnostic methods can very quickly identify the true cause of splenomegaly and begin its full-scale treatment.