Splenomegaly

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Splenomegaly

Splenomegaly is an enlargement of the spleen

Spleen

The spleen is an organ found in all vertebrate animals. In humans, the spleen is located in the abdomen of the body, where it functions in the destruction of redundant red blood cells, and holds a reservoir of blood....
, which usually lies in the left upper quadrant (LUQ) of the human abdomen

Human abdomen

The human abdomen is the part of the body between the pelvis and the chest. Anatomically, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim....
. It is one of the four cardinal signs of hypersplenism, the other three being cytopenia

Cytopenia

Cytopenia is a reduction in the number of blood cells. It takes a number of forms:*Low red blood cell count: anemia.*Low white blood cell count: leukopenia or neutropenia ....
(s), normal or hyperplastic bone marrow, and a response to splenectomy

Splenectomy

A splenectomy is a procedure that involves the removal of the spleen by Surgery means....
. Splenomegaly is usually associated with increased workload (such as in hemolytic anemia

Hemolytic anemia

Hemolytic anemia is anemia due to hemolysis, the abnormal breakdown of red blood cells either in the blood vessels or elsewhere in the body . It has numerous possible causes, ranging from relatively harmless to life-threatening....
s), which suggests that it is a response to hyperfunction. It is therefore not surprising that splenomegaly is associated with any disease

Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
process that involves abnormal red blood cell

Red blood cell

Red blood cells are the most common type of blood cell and the vertebrate body's principal means of delivering oxygen to the body tissues via the blood....
s being destroyed in the spleen.

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Encyclopedia

Splenomegaly is an enlargement of the spleen

Spleen

Human abdomen

Cytopenia

Splenectomy

A splenectomy is a procedure that involves the removal of the spleen by Surgery means....
. Splenomegaly is usually associated with increased workload (such as in hemolytic anemia

Hemolytic anemia

Disease

Red blood cell

Red blood cells are the most common type of blood cell and the vertebrate body's principal means of delivering oxygen to the body tissues via the blood....
s being destroyed in the spleen. Other common causes include congestion due to portal hypertension

Portal hypertension

In medicine, portal hypertension is hypertension in the portal vein and its tributaries.It is often defined as a portal pressure gradient of 5 mm Hg or greater....
and infiltration by leukemias and lymphomas. Thus, the finding of an enlarged spleen; along with caput medusa; is an important sign of portal hypertension.

Definition

Splenomegaly is defined as spleen size > 12cm.

Symptoms and signs

Symptoms may include abdominal pain

Abdominal pain

Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom....
, early satiety due to splenic encroachment, or the symptoms of anemia

Anemia

Anemia or an?mia/anaemia is defined as a qualitative or quantitative deficiency of hemoglobin, a protein found inside red blood cells ....
due to accompanying cytopenia.

Sign

Medical sign

A medical sign is an Objectivity indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
s of splenomegaly may include a palpable left upper quadrant abdominal mass

Abdominal mass

An abdominal mass is any localized enlargement or swelling in the human abdomen. Depending on its location, the abdominal mass may be caused by an enlarged liver , enlarged spleen , protruding kidney, a pancreatic mass, a retroperitoneal mass , an abdominal aortic aneurysm, or various tumours, such as those caused by abdominal carcinomatosis...
or splenic rub. It can be detected on physical examination

Physical examination

File:Reeve 978.jpgPhysical examination or clinical examination is the process by which a health care provider investigates the body of a patient for sign of disease....
by using Castell's sign

Castell's sign

Castell's sign is a sign assessed to evaluate splenomegaly and typically part of an abdominal examination. It is an alternative physical examination maneuver to Traube's sign....
or Traube's space

Traube's space

Traube's space is an anatomic region of some clinical importance. It's a crescent-shaped space, encompassed by the lower edge of the left lung, the anterior border of the spleen, the left costal margin and the inferior margin of the left lobe of the liver....
, but an ultrasound

Ultrasound

Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing . Although this limit varies from person to person, it is approximately 20 Hertz in healthy, young adults and thus, 20 kHz serves as a useful lower limit in describing ultrasound....
can be used to confirm diagnosis.

Causes

Splenomegaly grouped on the basis of the pathogenic mechanism
Increased function	Abnormal blood flow	Infiltration
*Removal of defective RBCs* spherocytosis Spherocytosis Spherocytosis is an auto-hemolysis anemia characterized by the production of red blood cells , or erythrocytes, that are sphere-shaped, rather than bi-concave disk shaped.... thalassemia Thalassemia Thalassemia is an inherited autosomal recessive blood disease. In thalassemia, the genetic defect results in reduced rate of synthesis of one of the globin chains that make up hemoglobin.... hemoglobinopathies nutritional anemias early sickle cell anemia *Immune hyperplasia* Response to infection (viral,bacterial,fungal,parasitic) mononucleosis Mononucleosis Mononucleosis is a condition where there is an unusual proliferation of monocytes. Its meaning is similar to the condition of monocytosis.Sometimes, the use of the term implies Epstein-Barr virus , but it is also possible for cytomegalovirus to cause mononucleosis.... , AIDS AIDS Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the HIV .... , viral hepatitis Viral hepatitis Viral hepatitis is Hepatitis due to a viral infection. It may present in acute or chronic forms. The most common causes of viral hepatitis are the five unrelated hepatotropic viruses Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E.... subacute bacterial endocarditis, bacterial septicemia splenic abscess Abscess An abscess is a collection of pus that has accumulated in a cavity formed by the tissue on the basis of an infection process or other foreign materials .... , typhoid fever Typhoid fever Typhoid fever, also known as enteric fever, or commonly just typhoid, is an illness caused by the bacterium Salmonella typhi. Common worldwide, it is transmitted by the ingestion of food or water contaminated with feces from an infected person.... brucellosis Brucellosis Brucellosis, also called undulant fever, or Malta fever, is a highly contagious zoonosis caused by ingestion of Sterilization_ milk or meat from infected animals, or close contact with their secretions.... , leptospirosis, tuberculosis Tuberculosis Tuberculosis is a common and often deadly infectious disease caused by mycobacterium, mainly Mycobacterium tuberculosis . Tuberculosis usually attacks the lungs but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, the gastrointestinal system, bones, joints, and even the... histoplasmosis Histoplasmosis Histoplasmosis, also known as Darling's disease,is a disease caused by the fungus Histoplasma capsulatum. Symptoms of this infection vary greatly, but the disease primarily affects the lungs.... malaria Malaria Malaria is a Vector -borne infectious disease caused by protozoan parasites. It is widespread in Tropics and subtropical regions, including parts of the Americas, Asia, and Africa.... , leishmaniasis Leishmaniasis Leishmaniasis is a disease caused by protozoan parasites that belong to the genus Leishmania and is transmitted by the bite of certain species of sand fly .... , trypanosomiasis Trypanosomiasis Trypanosomiasis or trypanosomosis is the name of several diseases in vertebrates caused by parasite protozoan trypanosomes of the genus Trypanosoma.... ehrlichiosis Ehrlichiosis Ehrlichiosis is a tick-borne disease of dogs usually caused by the organism Ehrlichia canis. Ehrlichia canis is the pathogen of animals.... Disordered immunoregulation rheumatoid arthritis Rheumatoid arthritis Rheumatoid arthritis is a chronic, systemic disease inflammation that may affect many tissues and organs, but principally attacks the joints producing a inflammatory synovitis that often progresses to destruction of the articular cartilage and ankylosis of the joints.... SLE SLE SLE can mean:* Supporting Leading Edge, a term used to describe a structure of a power kite* Systemic lupus erythematosus, an autoimmune disease affecting multiple systems in the body... Serum sickness Serum sickness Serum sickness is a reaction to proteins in antiserum derived from an animal source. It is a type of hypersensitivity, specifically immune complex hypersensitivity .... Autoimmune hemolytic anemia Autoimmune hemolytic anemia Autoimmune hemolytic anemia is a type of hemolytic anemia where the body's immune system attacks its own red blood cells , leading to their destruction .... Immune thrombocytopenia Idiopathic thrombocytopenic purpura Idiopathic thrombocytopenic purpura is the condition of having a low platelet platelet count of no known cause . As most causes appear to be related to antibody against platelets, it is also known as immune thrombocytopenic purpura or immune-mediated thrombocytopenic purpura.... sarcoidosis Sarcoidosis Sarcoidosis, also called sarcoid or Besnier-Boeck disease, is a multisystem disorder characterized by non-caseating granulomas . It most commonly arises in young adults.... drug reactions *Extramedullary hematopoiesis* Myelofibrosis Myelofibrosis Myelofibrosis, also known as myeloid metaplasia, chronic idiopathic myelofibrosis, and primary myelofibrosis, is a disorder of the bone marrow, in which the marrow undergoes fibrosis - replacement by fibrous tissue .... Marrow infiltration by tumors, leukemias marrow damage by radiation Radiation In physics, radiation describes any process in which energy emitted by one body travels through a medium or through space, ultimately to be absorbed by another body.... , toxins	*Organ Failure* cirrhosis Cirrhosis Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver Tissue by fibrous scar tissue as well as regenerative Nodule , leading to progressive loss of liver function.... congestive heart failure Congestive heart failure Heart failure is a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs.... *Vascular* hepatic vein obstruction portal vein obstruction Portal vein thrombosis Portal vein thrombosis is a form of venous thrombosis affecting the hepatic portal vein, which can lead to portal hypertension and reduction in the blood supply to the liver.... Budd-Chiari syndrome Budd-Chiari syndrome In medicine , Budd-Chiari syndrome is the clinical picture caused by occlusion of the hepatic veins. It presents with the classical triad of abdominal pain, ascites and hepatomegaly.... splenic vein obstruction *Infections* hepatic schistosomiasis Schistosomiasis Schistosomiasis is a parasitic disease caused by several species of Trematoda of the genus Schistosoma.Although it has a low mortality rate, schistosomiasis often is a chronic illness that can damage internal organs and, in children, impair growth and cognitive development.... hepatic echinococcosis Echinococcosis Echinococcosis, also known as hydatid disease, hydatid cyst, unilocular hydatid disease or cystic echinococcosis, is a potentially fatal parasitic disease that can affect many animals, including wildlife, commercial livestock and humans.... \|*Metabolic diseases* Gauchers disease Niemann-Pick disease Niemann-Pick disease Niemann-Pick disease refers to a group of fatal inherited metabolic disorders that are included in the larger family of lysosomal storage diseases .... Alpha-mannosidosis Alpha-mannosidosis Alpha-mannosidosis is an autosomal recessive lysosomal storage disorder caused by deficient activity of the enzyme alpha-D-mannosidase.... Hurler syndrome Hurler syndrome Hurler syndrome, also known as mucopolysaccharidosis type I , Hurler's disease or gargoylism, is a genetic disorder that results in the buildup of mucopolysaccharides due to a deficiency of alpha-L iduronidase, an enzyme responsible for the degradation of mucopolysaccharides in lysosomes.... and other Mucopolysaccharidoses Amyloidosis Amyloidosis In medicine, amyloidosis refers to a variety of conditions in which amyloid proteins are abnormally deposited in organ s and/or Tissue s. A protein is described as being amyloid if, due to an alteration in its secondary structure, it takes on a particular aggregated insoluble form similar to the beta-pleated sheet.... Tangier disease Tangier disease Tangier disease is a rare inherited disorder characterized by a severe reduction in the amount of high density lipoprotein , often referred to as "good cholesterol," in the bloodstream.... *Benign and malignant infiltrations* Leukemias(acute,chronic,lymphoid and myeloid) lymphomas(Hodgkins Hodgkins Hodgkins may refer to:Hodgkin's lymphoma, a type of cancerFrances Hodgkins, an abstract painterW. M. Hodgkins, New Zealand painter, father of Frances Hodgkins... and non-hodgkins Non-Hodgkin lymphoma The non-Hodgkin lymphomas* are a diverse group of hematological malignancy which encompass any lymphoma other than Hodgkin lymphoma.Lymphoma is a type of cancer derived from lymphocytes, a type of white blood cell.... ) myeloproliferative disorders metastatic tumors(commonly melanoma Melanoma Melanoma is a malignant tumor of melanocytes which are found predominantly in skin but also in the bowel and the eye . It is one of the rarer types of skin cancer but causes the majority of skin cancer related deaths.... ) histiocytosis X Hemangioma Hemangioma A hemangioma is a congenital benign tumour or vascular malformation of endothelial cells .In infancy, it is the most common tumor.... ,lymphangioma Lymphangioma Lymphangioma is a lymphatic malformation, a benign proliferation of lymph vessels, forming a yellowish tumor on the skin, composed of a mass of dilated lymph vessels.... splenic cysts hamartomas eosinophilic granuloma

The causes of massive splenomegaly (>1000 g) are much fewer and include:

thalassemia
Thalassemia

Thalassemia is an inherited autosomal recessive blood disease. In thalassemia, the genetic defect results in reduced rate of synthesis of one of the globin chains that make up hemoglobin....
visceral leishmaniasis
Visceral leishmaniasis

Visceral leishmaniasis , also known as kala-azar and black fever, is the most severe form of leishmaniasis. Leishmaniasis is a disease caused by protozoan parasites of the Leishmania genus....
(Kala Azar)
schistosomiasis
Schistosomiasis

Schistosomiasis is a parasitic disease caused by several species of Trematoda of the genus Schistosoma.Although it has a low mortality rate, schistosomiasis often is a chronic illness that can damage internal organs and, in children, impair growth and cognitive development....
chronic myelogenous leukemia
Chronic myelogenous leukemia

Chronic myelogenous leukemia , also known as chronic granulocytic leukemia , is a form of leukemia characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow and the accumulation of these cells in the blood....
chronic lymphocytic leukemia
Chronic lymphocytic leukemia

B-cell chronic lymphocytic leukemia , is a type of leukemia, or cancer of the white blood cells . CLL affects a particular lymphocyte, the B cell, which originates in the bone marrow, develops in the lymph nodes, and normally fights infection....
lymphomas
hairy cell leukemia
Hairy cell leukemia

Hairy cell leukemia is a mature B cell neoplasm. It is usually classified as a sub-type of chronic lymphoid leukemia for convenience. It is uncommon, representing about 2% of all leukemias, or less than a total of 2000 new cases diagnosed each year in North America and Western Europe combined....
myelofibrosis
Myelofibrosis

Myelofibrosis, also known as myeloid metaplasia, chronic idiopathic myelofibrosis, and primary myelofibrosis, is a disorder of the bone marrow, in which the marrow undergoes fibrosis - replacement by fibrous tissue ....
polycythemia vera
Polycythemia vera

Primary polycythemia, often called polycythemia vera , polycythemia rubra vera , or erythremia, occurs when excess red blood cells are produced as a result of an abnormality of the bone marrow and occasionally in the kidneys....
Gauchers disease
Niemann Pick disease
sarcoidosis
Sarcoidosis

Sarcoidosis, also called sarcoid or Besnier-Boeck disease, is a multisystem disorder characterized by non-caseating granulomas . It most commonly arises in young adults....
autoimmune hemolytic anemia
Autoimmune hemolytic anemia

Autoimmune hemolytic anemia is a type of hemolytic anemia where the body's immune system attacks its own red blood cells , leading to their destruction ....
malaria
Malaria

Malaria is a Vector -borne infectious disease caused by protozoan parasites. It is widespread in Tropics and subtropical regions, including parts of the Americas, Asia, and Africa....

Treatment

If the splenomegaly underlies hypersplenism, a splenectomy

Splenectomy

A splenectomy is a procedure that involves the removal of the spleen by Surgery means....
is indicated and will correct the problem. After splenectomy, however, patients have an increased risk for infectious diseases.

After splenectomy, patients should be vaccinated

Vaccine

A vaccine is a biological preparation that establishes or improves immunity to a particular disease.Vaccines can be prophylaxis , or Medication ....
against Haemophilus influenzae
Haemophilus influenzae

Haemophilus influenzae, formerly called Pfeiffer's bacillus or Bacillus influenzae, is a non-motile Gram-negative coccobacillus first described in 1892 by Richard Friedrich Johannes Pfeiffer during an influenza pandemic....
and Streptococcus pneumoniae
Streptococcus pneumoniae

Streptococcus pneumoniae, or pneumococcus, is a Gram-positive, Hemolysis diplococcus aerotolerant anaerobe and a member of the genus Streptococcus....
. They should receive annual influenza vaccinations. Long-term prophylactic

Prophylaxis

Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. Roughly, prophylactic measures are divided between primary prophylaxis and secondary prophylaxis ....
antibiotic

Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
s should be given.

External links

(Hypersplenism)

Splenomegaly

Definition

Symptoms and signs

Causes

Treatment

See also

External links