Splenomegaly – Definition, Causes, and Treatment.

Definition

An enlarged spleen, known formally as splenomegaly, is a medical condition in which a person or animal’s spleen increases in size due to some sort of inflammation or other problem. The swelling doesn’t usually cause any immediate symptoms or pain, and as such people aren’t usually aware of what’s going on. If left untreated it can be very dangerous, though. Most enlargements are a consequence or side effect of some larger, often more serious condition, commonly infection, anemia, or blood cancer. In some of these cases, the spleen acts as a sort of diagnostic marker that can prompt early treatment and, in many cases, a better outcome. There isn’t usually a specific course of treatment to reduce swelling of this organ on a universal level.

Types of Splenomegaly

Depending on the reasons for this pathological condition, its treatment may be different. It should be specially noted that today very often patients speak of a diagnosis such as “splenomegaly of the liver”. Although this term is not entirely correct, in reality, an increase in the spleen is often accompanied by an increase in other internal organs. Such a picture can significantly worsen a patient’s condition and treatment.

Moderate splenomegaly – It is an increase in the spleen, which arose as a result of some pathological phenomena from the side.

Hepatomegaly is a kind of enlargement of the liver, which is combined with an increase in the above-mentioned organ.

Hepatolienal syndrome is a simultaneous increase in both the spleen and the liver.

Risk factors

The risk factors associated with Splenomegaly include:

• Individuals affected with sickle cell and hemolytic anemia, especially prevalent in an African-American population
• Individuals affected with Niemann Pick disease and Gaucher disease, especially prevalent in people of Ashkenazi-Jewish descent
• Children and young adults affected with severe infections, such as mononucleosis
• Residing in malaria-endemic regions; traveling to areas where malaria is widespread
• Those with certain chronic conditions, such as rheumatoid arthritis or lupus, are more susceptible to Enlarged Spleen

Causes of Splenomegaly

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 before inflammatory diseases and ailments of blood cells.

Consider the most common causes of an 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.).

Symptoms

An enlarged spleen may cause:

• No symptoms in some cases
• Pain or fullness in the left upper abdomen that may spread to the left shoulder
• Feeling full without eating or after eating only a small amount from the enlarged spleen pressing on your stomach
• Anemia
• Fatigue
• Frequent infections
• Easy bleeding

Symptoms of spleen

Complications of Splenomegaly

Potential complications of an enlarged spleen are:

Infection: An enlarged spleen can reduce the number of healthy red blood cells, platelets and white cells in your bloodstream, leading to more frequent infections. Anemia and increased bleeding also are possible.

Ruptured spleen: Even healthy spleens are soft and easily damaged, especially in car crashes. The possibility of rupture is much greater when your spleen is enlarged. A ruptured spleen can cause life-threatening bleeding into your abdominal cavity.

Diagnosis and test

Diagnosing splenomegaly involves a number of tests, including:

• Physical examination
• Ultrasound or abdominal x-ray
• Computed tomography (CT) scan
• Blood tests, to check for underlying disorders.

Treatment and medications

The treatment methods for Splenomegaly may involve the following:

• In cases where the individual has an Enlarged Spleen without symptoms, a healthcare professional may opt to wait several months, before deciding on a course of action
• Surgical removal of the spleen, through a splenectomy, in very serious and critical cases
• Once a decision to remove the spleen is made, the individual is advised to take certain vaccinations, both before and after the surgery, to protect him/her from infections.

The recommended vaccinations may include:

• Pneumococcal vaccine
• Meningococcal vaccine
• Haemophilus influenzae type B vaccine
• It is also advised that the individual get a pneumococcal vaccine, once every 5 years, following the removal of the spleen
• Antibiotics, such as penicillin, may be prescribed to combat infections post-surgery
• Treatment of the underlying condition depending on the cause

Prevention for Splenomegaly

• Prevention of splenomegaly in itself may be meaningless. Some of the medical causes of splenomegaly, however, may be preventable, such as cessation of alcohol abuse to prevent liver cirrhosis, or prophylaxis against malaria when planning a trip to an endemic area.
• Preventive measures against a possible rupture of the spleen are noteworthy. Avoiding contact sports and wearing seatbelts are important measures to take for the prevention of splenic rupture.
• Proper vaccination in patients with splenectomy is also of great significance as noted earlier.