Splenomegaly - what is it? Symptoms, causes, treatment of splenomegaly

Splenomegaly - what is it? The answer to the question you ask will be given below. In addition, we will talk about why this disease occurs, what are its symptoms, the processes of its diagnosis and treatment.

General information

Splenomegaly - what is it? In medical practice, this term refers to a disease characterized by a significant increase in the spleen. As a rule, this occurs 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 the increase in this body is considered splenomegaly, is always conditional. So, in a normal state, the mass of the spleen in an adult is about 100-150 g. When palpating a healthy organ should not exceed 7 centimeters (diagonally). The diagnosis of "splenomegaly of the spleen" is rarely set. This happens under the following conditions:

• If the size of the body exceeds the said value;
• If the splenic dullness is abnormally intense;
• If the spleen is clearly palpated.

The role of the spleen in the human body

Splenomegaly - what is it? The answer to the question we have discussed above. The spleen is the most important 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 more precisely - under the diaphragm. In this case, the spleen is bent between the 9th and 11th ribs. A healthy adult weighs about 150 grams. It covers a site in the abdominal cavity measuring about 11 centimeters in the vertical direction.

Functions of the spleen

The organ represented plays an important role in the human body. His job is to exclude foreign organisms or bacteria from the circulation, as well as to develop antibodies for the immune system and remove abnormal blood cells.

It should be specially noted that the spleen can grow 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 are often the reasons for its large size. However, the diagnosis of "splenomegaly" is made in rare cases. After all, the increase in this body 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 body can weigh about 500 grams, and its largest size - vary from 11 to 20 centimeters. Splenomegaly, the reasons for which we will consider below, accompanied by a body 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 causes of this pathological condition. They are diverse and often vary from malignant tumors (cancer), overloads (or a strong increase in blood flow), infections and infiltration of the body 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 (eg, leukemia, lymphoma or myelofibrosis);
• Diseases of blood cells (eg, spherocytosis, thalassemia or sickle-cell anemia);
• Liver disease (eg, chronic hepatitis C, cirrhosis due to chronic hepatitis B, prolonged use of alcoholic beverages and fatty liver disease) ;
• Inflammatory diseases (rheumatoid arthritis and lupus erythematosus);
• Gaucher's disease (or ailment of lipid metabolism);
• Abnormal blood flow and blockage of blood vessels, veins (eg, spleen vein thrombosis, congestive heart failure and portal vein blockage);
• Thrombocytopenic idiopathic purpura;
• Various infections (bacterial endocarditis, mononucleosis, AIDS, malaria, leishmania, mycobacteria, etc.).

Splenomegaly: symptoms of the disease

As is known, such a deviation, as splenomegaly, does not have specific symptoms. However, the most common among them are fuzzy pains in the abdominal cavity and bloating. All listed signs of splenomegaly are considered nonspecific. It should be specially noted that some people with a greatly enlarged spleen often complain of rapid saturation and symptoms of gastric reflux.

The last sign of the disease is due to the fact that because of the pressure on the abdominal cavity begins to shift the stomach.

In other cases, the symptoms that are associated with an increase in this body, include the following:

• Night sweats;
• Fever;
• Weight loss;
• General weakness;
• pallor;
• Easy bruising;
• fatigue.

When and whom should I seek medical help?

Splenomegaly in children and adults requires compulsory observation from an experienced doctor. However, not every person who has such a pathological condition, knows to which doctor he should apply. In this regard, it should be noted that the choice of a particular specialist depends, first of all, on what has contributed to the development of this disease. Thus, patients can refer to a hematologist (a doctor who specializes in the treatment of blood diseases), an oncologist (a specialist in cancer tumors) and a gastroenterologist (specialist in diseases of the digestive tract, including the liver). After going to the doctor, the latter should conduct a full medical examination, and then appoint an effective treatment.

Depending on the causes of the disease, people with this diagnosis may need urgent hospitalization. Typically, this occurs if patients have intolerable abdominal pain, as well as bleeding symptoms and infections not subject to home treatment.

Inspection

After contacting a specialist, the patient will firstly be examined. To do this, doctors use methods of palpation and percussion. With the help of such methods they determine the size of the spleen. In a normal state, about 3% of people have an easily palpable organ. However, the palpable mass in the upper left part of the abdominal cavity may be due to an entirely different reason, rather than an enlarged spleen. That's why experts use other methods of diagnosis.

If splenomegaly was not detected on palpation, but all the symptoms indicate its presence, a general blood test can be assigned to the patient. In the course of such a study, experts assess the composition, shape and amount of white blood cells, platelets and red blood cells. These indicators can also disprove or confirm the presence of the disease.

Diagnosis of splenomegaly

If after examination and delivery of a number of tests specialists doubt the results, then ultrasound examination, as well as computer and magnetic resonance imaging, are performed for more accurate diagnosis. These methods are able to provide a detailed image of the internal organs, and therefore, with high accuracy determine the presence or absence of a disease. It should also be noted that magnetic resonance imaging is particularly effective during the determination of splenic vein thrombosis or portal thrombosis.

In addition to all the others, a radioisotope study is used to diagnose such a disease. This is a highly accurate method that is able to clearly identify the details of the tissues of the spleen. However, the presented method is not easy to perform and very expensive.

Types of the disease

Depending on the causes of such a pathological condition, his treatment may be different. It should be specially noted that today very often patients talk about such a diagnosis as "splenomegaly of the liver". Although this term is not entirely correct, but in reality the enlargement of the spleen is often accompanied by an increase in other internal organs. Such a picture can significantly worsen the patient's condition and treatment.

1. Moderate splenomegaly - what is it? This is an increase in the spleen, which arose as a result of some pathological phenomena from the side.
2. Hepatomegaly is a kind of enlargement of the liver, which is combined with an increase in the above-mentioned organ.
3. Hepatolyenal syndrome is a simultaneous increase in both the spleen and the liver.

Treatment of the disease

What if the patient is diagnosed with splenomegaly? Treatment of this body should be directed to the primary cause of the onset of the disease. After all, as we know, this disease is only a manifestation of another pathology. It is also worth noting that the enlarged spleen does not need to be treated until a severe hypersplenism develops in the patient's body.

Often, in parallel with the therapy of the underlying disease, specialists carry out a series of measures to improve the patient's condition and treat splenomegaly. Such procedures include the following:

• Transfusion of leukocyte mass;
• Transfusion of platelet mass;
• Treatment of the patient with glucocorticoids (with the prescription "Prednisolone" in the amount of 20-40 milligrams per day for 4-6 months);
• Removal of an enlarged organ or splenectomy.

Surgical intervention

Splenectomy is rarely performed by specialists. As a rule, such an operation is aimed at combating the underlying disease. Usually splenectomy is performed with such pathological conditions as thalassemia, blockage of splenic veins, Gauchers disease and leukemia. The decision to remove the enlarged spleen is taken by the doctor individually for each patient. This depends on the situation and the likely risk to the patient's life. After all, with severe damage to the body, a rupture of the spleen may occur, which will lead to internal hemorrhage. By the way, it is for this reason that patients who are diagnosed with splenomegaly are categorically prohibited from doing sports and any physical labor.

What threatens the removal of the spleen?

The absence of this organ, or so-called aspiration, carries a sufficiently 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 the operation on splenectomy, it is necessary to vaccinate against all the listed bacteria.

Recovery

Splenomegaly itself is incurable. After all, it represents only the reaction of the spleen to any other pathologies in the human body. In case of anemia, the patient is prescribed iron and arsenic. If this deviation is accompanied by thrombopenia and leukopenia, then the doctors remove the inflamed organ. It should be specially noted that after the operation, the patient immediately noted an increase in the number of platelets and white blood cells, signs of hemorrhagic diathesis disappear, the patient noticeably adds weight and improves his overall condition. If a teenager with such a diagnosis had a delay in growth, then after splenectomy everything comes back to normal. If by the time of the operation the patient had no depletion of the body, and no changes in the part of the organs and bones were observed, then a remission comes rather quickly.

Let's sum up the results

In general, a diagnosis such as splenomegaly is not as dangerous as its underlying disease. It should be specially noted that in modern medical practice there were many cases when even a greatly enlarged spleen returned to its normal size after the combined therapy of the underlying disease. Part of this is due to the fact that existing methods of diagnosis can very quickly reveal the true cause of splenomegaly and start its full-scale treatment.