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Every organ human body has an individual shape and size. Normally, these characteristics are approximately the same for different people, however, the development of a particular disease can lead to changes in indicators.
For example, a pathological decrease or, conversely, an increase in an organ is by no means a rare phenomenon.
Splenomegaly - what is it?
Sometimes you can hear from a doctor that a patient has an enlarged spleen or “splenomegaly.” It is difficult for people far from medicine to understand this issue: is it a diagnosis or what is it? Splenomegaly– this is an abnormal enlargement of the spleen associated with the occurrence of any pathological process in the body and is not an independent disease. In simple words- this is a symptom, increased.
The symptom itself is not dangerous, but in any case, an in-depth diagnosis aimed at identifying the causes is required.
Normally, the length of the spleen does not exceed 12 cm in an adult; this organ weighs about 100-150 grams and is not detectable by palpation. The only exceptions are very thin people.
Moderate splenomegaly is an enlargement of the spleen, in which its length is in the range of 13-20 cm and its weight is 400-500 grams. If these values begin to exceed the threshold levels of 21 cm and 1000 grams, respectively, they speak of a severe form.
IN human body The spleen performs a hematopoietic function and is one of the main blood depots, which contains red blood cells, platelets and leukocytes. In addition to producing red blood cells, this organ is responsible for the production of white blood cells - leukocytes. This is how the immune function of the spleen is realized.
However, in this organ not only blood cells are formed, but also damaged and old ones are destroyed. The spleen is also responsible for the synthesis of certain protein structures, in particular immunoglobulins.
Splenomegaly in adults can occur when the body seeks to compensate for the deficiency of certain components. For example, with anemia caused by low hemoglobin in the blood, or with a powerful immune response, when the spleen produces great amount immunoglobulin. In addition, many infections cause mild splenomegaly.
Splenomegaly in children, features
If an enlarged spleen in adults is a possible signal about the development of a pathological process in the body, then splenomegaly in children is not always a cause for concern.
Normally, the spleen of some babies may slightly exceed the maximum threshold values taking into account age. Thus, in a newborn, a deviation in the length of this organ of up to 30% is considered acceptable. By six months of age, the spleen can exceed the maximum threshold length by 15%, and by three years it can differ from the norm by only 3%.
If a baby is diagnosed with splenomegaly, he should mandatory a full complex is prescribed diagnostic procedures. You need to pass the general and biochemical tests blood, examine urine, conduct a stool examination - a coprogram.
Since a common cause of spleen enlargement in children is helminthic infestations and infections, examination of stool for worm eggs, immunological analysis for the presence of protozoa and bacteriological examination blood to identify the infectious agent and its drug resistance.
The doctor receives basic data on the degree of enlargement of the organ, its structure, the presence or absence of neoplasms in it after an ultrasound scan of the spleen. Treatment will be required if any pathologies that trigger the development of splenomegaly are identified.
However, there are situations when an enlarged spleen in a child is not a sign of pathology. This symptom is just a reason for a serious examination, but not necessarily a warning about the danger of a serious illness.
Signs and forms of splenomegaly, symptoms
Splenomegaly, as noted above, is not a disease, but possible symptom pathology. The main causes of splenomegaly are infections, autoimmune conditions, diseases of the blood and hematopoietic organs, circulatory disorders, metabolic disorders, abscesses, infarctions of the organ and neoplasms in it.
Infections leading to an enlarged spleen can be caused by pathogens of various natures:
- bacteria;
- viruses;
- protozoa;
- helminths;
- fungi.
Infections
The cause of splenomegaly can be a bacterial infection occurring in acute or chronic form. An enlarged spleen is observed in the following acute conditions:
- sepsis;
- miliary tuberculosis;
- diseases from the typhoid-paratyphoid group, the causative agents of which are Salmonella microorganisms.
In addition, splenomegaly is observed with chronic course syphilis, brucellosis, splenic tuberculosis. In the latter case, predominant damage is observed only in a specific organ, whereas with syphilis other structures also suffer.
Viruses
Speaking about viral infections that lead to an enlarged spleen, mention should be made of measles, hepatitis, and Infectious mononucleosis. With measles and rubella, a rash covers the body, pathological changes are additionally observed in the lymph nodes.
Hepatitis viruses primarily infect the liver; the spleen is affected secondarily. She being immune organ, provides enhanced fight against the pathogen and increases with chronic hepatitis.
The development of infectious mononucleosis caused by is associated with damage not only to the spleen, but also to the liver and lymph nodes in the neck.
Protozoa
Protozoal infections are most common in tropical countries. Splenomegaly is most often caused by malaria and leishmaniasis. In the first case, pathological processes affect not only the spleen, but also other organs.
With leishmaniasis, the liver also suffers, and severe skin damage is possible. Another protozoal disease, common not only in southern latitudes, is toxoplasmosis - with this pathology, people suffer nervous system. Toxoplasmosis is often asymptomatic.
- Splenomegaly is recorded with acute form infections.
Infections, helminthic infestations, as well as abscesses and areas of infarction in the organ cause inflammatory enlargement of the spleen. In this case, the signs of splenomegaly are as follows:
- heat body (39-40˚С, sometimes up to 42˚С for typhoid, malaria, leishmaniasis, histoplasmosis, blastomycosis, echinococcosis);
- vomiting, nausea;
- sometimes diarrhea;
- pain in the left hypochondrium;
- painful palpation of the spleen.
However, in addition to inflammatory, enlargement of the spleen can also be non-inflammatory. This is typical for him clinical picture:
- normal body temperature or its slight increase (not higher than 37.5˚C);
- unexpressed, mild pain on palpation of the spleen;
- nagging discomfort in the left hypochondrium;
- rapid onset of satiety during meals, as the spleen compresses the stomach.
Non-inflammatory splenomegaly is observed with different types anemia, metabolic disorders of a congenital or acquired nature, portal hypertension, Pick's cirrhosis (involving, in addition to the liver, the heart and lungs), leukemia, lymphoma, myelofibrosis and autoimmune processes ( rheumatoid arthritis, systemic lupus erythematosus, periarteritis nodosa).
In addition, the spleen enlarges without accompanying inflammatory process with the development of tumors and cysts.
Since the clinical picture of non-inflammatory splenomegaly is nonspecific and rather blurred, a complete diagnosis is required to identify the pathology-cause. comprehensive diagnostics, including both laboratory and instrumental methods research.
How to treat splenomegaly?
Question - what is splenomegaly and how to treat it? — first of all arises in a person when he hears such a “strange” diagnosis for the first time. Since this condition develops against the background of some pathology, therapy should be carried out aimed at eliminating the root cause.
At infectious process caused by bacteria, antibiotics are indicated, and if the disease has a viral etiology, antiviral drugs are indicated.
Mycoses are treated with antifungal agents, and helminthic infestations are treated with anthelmintics. With echinococcosis, when cysts with larval forms of the pathogen grow into the spleen, it is only possible surgical removal.
Against the background of anemia, especially caused by vitamin B12 deficiency, vitamin therapy is indicated. Oncological diseases blood is treated with antitumor drugs. To relieve severe inflammation of the spleen and suppress overly activated immunity, use hormonal drugs.
Unfortunately drug treatment splenomegaly does not always give results. If there is no positive dynamics and the spleen continues to grow in size, a malfunction in its functioning leads to excessive destruction of blood cells (hypersplenism) - surgical removal of the organ is indicated.
- The same tactics are followed when a malignant tumor is detected.
Possible complications
Splenomegaly requires attentive attitude patient and regular monitoring by the attending physician, especially if it develops against the background of a chronic infection. Most dangerous complication When the spleen enlarges, it ruptures. It can be caused by increased physical exercise, bruises, injuries received, including while playing contact sports.
In addition, splenomegaly is characterized by hypersplenism - increased filtration of blood cells with subsequent destruction. Against this background, a deficiency of erythrocytes, platelets and leukocytes develops, and hyperplasia (overdevelopment) also forms compensatoryly. bone marrow to restore normal blood cell concentrations.
It is undesirable to leave splenomegaly without diagnosis, since this can miss the development of serious, often life-threatening diseases.
It happens that during examination in patients with an enlarged spleen and without any clinical manifestations can't find any reason for this pathological condition. This result is not a reason to stop diagnosing. The examination should be repeated after 6-12 months.
Which doctor should I contact if my spleen is enlarged?
The spleen is a hematopoietic organ immune systems, therefore, if splenomegaly develops, you should visit a hematologist and immunologist. However, initial examination can be done by a therapist. This specialist will palpate the organ and, if necessary, prescribe ultrasound diagnostics and laboratory tests.
With the results obtained, the patient may be referred to a specialist. In addition to a hematologist and immunologist, this could be an infectious disease specialist, an oncologist or a surgeon.
I hope I explained what splenomegaly is and it became clear that an enlarged spleen in a child or adult is not a reason to panic. Pathology in children under 3 years of age in the absence of disease is a variant of the norm. For adults, if the cause of organ enlargement has not been found, they should undergo regular diagnostic tests. This way you will be able to protect yourself from complications of splenomegaly itself and identify dangerous ailments in time.
Splenomegaly (from the Greek splen “spleen”, megas “large”) is a term meaning an enlarged spleen. Splenomegaly is usually spoken of when the mass of this organ is more than 600 g. In this case, it can be felt in the left half of the abdomen in the hypochondrium.
The reasons for the enlargement of the spleen in size are varied, since this organ performs many functions in the body. various functions. Therefore, the causes of splenomegaly are usually classified according to the mechanisms of their development.
The following main types of splenomegaly are distinguished:
- "working" hypertrophy in response to systemic action toxins associated with the immune response to infection;
- hypertrophy associated with increased breakdown of blood cells in the spleen;
- enlargement of the spleen associated with stagnation of venous blood in it;
- increased formation of pathological blood cells in tumors of the blood and bone marrow;
- splenomegaly of mixed origin.
Causes
Left - spleen normal size, on the right - enlarged.Enlarged spleen during infectious and toxic processes
When antigens enter the body from external environment or under the influence of internal toxic factors, an intense immune process develops. The spleen actively participates in it, and its blood supply and the mass of cells contained in it increase.
An enlarged spleen is characteristic of many inflammatory, necrotic processes in the body. It occurs when acute infections(infectious mononucleosis, hepatitis, typhus, tularemia, sepsis, infective endocarditis). Splenomegaly is characteristic of such chronic infections, like , tuberculosis, malaria. It occurs in toxoplasmosis.
Enlarged spleen with increased breakdown of blood cells
The physiological process of destruction of outdated blood cells (erythrocytes, platelets, leukocytes) occurs in the spleen. For blood diseases accompanied by increased destruction of these shaped elements, there is a natural increase in the size of the spleen.
This mechanism of splenomegaly is characteristic of a number of anemias accompanied by the breakdown of red blood cells (so-called hemolytic anemia). These include congenital spherocytosis, autoimmune hemolytic anemia, sickle cell anemia.
Autoimmune diseases with the destruction of white blood cells (neutropenia) and platelets () may also sometimes be accompanied by an enlarged spleen.
With chronic hemodialysis, instability of blood cell membranes develops; they are easily destroyed. Therefore, during hemodialysis, the development of splenomegaly is also possible.
Stagnation of venous blood in the spleen
The venous network is well developed in the spleen. Therefore, when the outflow of venous blood from it is disrupted, it increases. When blood accumulates in this organ, vascular tissue begins to grow and the number of red blood cells increases. The so-called Banti disease develops.
Stagnation of blood in the spleen can occur when different processes, leading to increased pressure in the portal, splenic, and hepatic veins. These large veins may be compressed, for example, by a tumor abdominal cavity. Their lumen may be blocked by a thrombus. Liver cirrhosis leads to increased venous pressure. Severe cases with severe edema are also accompanied by stagnation of blood in the spleen and its enlargement.
Enlarged spleen in blood diseases
In the embryonic period, the spleen is a hematopoietic organ. Therefore, in case of blood diseases, new foci of hematopoiesis and metastases may appear. Sometimes there are primary tumors spleen.
Splenomegaly is accompanied by such serious diseases as subleukemic myelosis, chronic myeloid leukemia, chronic lymphocytic leukemia, lymphogranulomatosis, lymphoblastic leukemia, multiple myeloma, polycythemia vera, essential thrombocythemia, etc.
Enlarged spleen of mixed origin
Symptoms of splenomegaly
Splenomegaly may be accompanied by pain in the left hypochondrium, bloating, and a tendency to constipation. Symptoms of an enlarged spleen occur when it is of significant size and are associated with stretching of its capsule and compression of surrounding organs. Therefore, signs of an enlarged spleen may be aching pain in the left hypochondrium, constipation, bloating. When the stomach is compressed, a feeling of early satiety and lack of appetite occurs, as well as signs of reflux of stomach contents into the esophagus ().
An enlarged spleen is accompanied by signs of the disease that caused it. This may be weakness, sweating, fever, bleeding, weight loss, etc.
Treatment of splenomegaly
Treatment of splenomegaly is aimed at treating the underlying disease (treatment of an infectious-inflammatory process, reducing pressure in the veins of the abdominal cavity, chemotherapy for tumors, etc.).
Sometimes surgical removal of an enlarged spleen () is indicated, for example, with idiopathic thrombocytopenic purpura. In this disease, removal of the spleen leads to rapid recovery platelet level in the blood.
Splenectomy is also performed for Gaucher disease, hairy cell leukemia, and thalassemia.
After such an operation, a person’s susceptibility to pneumococcus, meningococcus and Haemophilus influenzae increases, so such patients are vaccinated against the corresponding microorganisms.
Which doctor should I contact?
If heaviness appears in the left hypochondrium, you should consult a therapist who will determine the primary diagnosis. Depending on the reason that caused the enlargement of the spleen, further treatment carried out by a hematologist, infectious disease specialist, endocrinologist, rheumatologist.
The spleen has a very great importance for the human body. In children, during intrauterine development, it is involved in the process of hematopoiesis. In adults, it fights pathogens and builds immunity. It is a repository for iron, which is so necessary for the creation of hemoglobin. Blood accumulates in it, which, if there is a sharp shortage, will immediately go into the bloodstream. But under the influence of some negative factors and diseases, the spleen can pathologically increase in size and reach gigantic sizes, filling more than half of the abdominal cavity. This condition is called splenomegaly and can lead to rupture of this unpaired organ, complications concomitant diseases and to a decrease in blood cells with the subsequent development of anemia, leukopenia or thrombocytopenia.
Causes of splenomegaly and main symptoms
Splenomegaly is not an independent disease; an enlarged spleen occurs against the background of other diseases. The reasons that provoke pathological enlargement of the spleen are described below.
Chronic bacterial infections:
- Splenic tuberculosis – left-sided moderate abdominal pain, fever up to 40˚C, nausea.
- Brucellosis – the same symptoms with the addition of diarrhea.
- Syphilis - damage to lymph nodes and others internal organs, temperature up to 41˚C.
Acute bacterial infections:
- Typhoid diseases - severe pain in the abdomen and diarrhea, high body temperature.
- Miliary tuberculosis – damage to internal organs with an increase in temperature up to 42˚C.
- Sepsis.
Acute and chronic bacterial infections are very common reasons splenomegaly.
The reasons why splenomegaly occurs may be hidden in liver disease. These are liver cirrhosis, cystic fibrosis, portal hypertension ( high blood pressure V portal vein), biliary atresia (obstruction or absence). Very often, an enlargement of the spleen occurs against the background of the appearance malignant neoplasms in organism.
Splenomegaly is a natural symptom in children with portal hypertension. In children, symptoms in this case manifest themselves in an increase in abdominal volume and flatulence, increased venous vessels peritoneum, sometimes there is ascites (accumulation of free fluid).
Specific symptoms of splenomegaly are frequent hiccups, abdominal pain (above left), and the body's inability to take in large amounts of food.
Diagnosis of splenomegaly
A patient comes to the doctor with complaints of pain in the left hypochondrium, nausea and unstable loose stool, accompanied elevated temperature bodies.
After a visual examination of the patient, the doctor palpates the painful area on the abdomen and detects an enlarged spleen. To find out the reasons for this pathological condition, the therapist asks several questions about the events in the patient’s life that could lead to this: whether there were any trips to exotic countries, what was eaten, etc. An anamnesis of the disease and a family history are collected (the presence of diseases of the blood, gastrointestinal tract, spleen and liver in relatives is determined).
To find out the causes of the disease splenomegaly and prescribe correct treatment, a number of laboratory tests are done:
- A clinical blood test that will reveal possible anemia. An increased level of leukocytes in the blood will indicate an inflammatory process occurring in the body.
- Blood test for biochemistry. It makes it possible to evaluate the functioning of the pancreas and liver, as well as determine the amount of important microelements.
- General urine analysis (condition of the genitourinary system).
- Stool analysis (performance assessment digestive system).
- Analysis of stool for worm eggs.
- Coagulogram (blood clotting test).
- Blood culture to determine the causative agent of infection in the body.
Additional studies to determine the cause of splenomegaly are based on instrumental methods:
- Ultrasound of the abdominal cavity to check all its organs. The examination confirms an abnormally enlarged spleen. In newborns, the normal length of the spleen is 40 mm, in children 3-7 years old - 80 mm, in an adult - 120 mm with a weight of approximately 160 g. With splenomegaly, these figures are greatly exceeded.
- CT ( CT scan) abdominal organs for a more thorough examination or detection of possible malignant tumors.
- Genetic studies to identify hereditary diseases, causing disease splenomegaly.
- Autoimmune biochemical markers (immune system check).
- Sternal puncture (puncture of the sternum to remove bone marrow for examination and determination of tumors of hematopoietic tissues).
Consultation with a hematologist can help determine the causes of the disease.
Treatment of an enlarged spleen
For treatment of the disease to be successful, splenomegaly must be correctly and correctly diagnosed for all probable reasons development.
Treatment is carried out using antibacterial drugs(if splenomegaly has a bacterial etiology). Treatment of tumors and diseases hematopoietic system consists of application antitumor drugs. Hormonal drugs and vitamin therapy are widely used.
If conservative treatment does not bring results, is prescribed surgery(splenectomy).
There are no measures to prevent the development of this pathology, but a person can prevent the diseases that provoke it - do not smoke, do not abuse alcohol, do all vaccinations before traveling, routine vaccinations. A person with a spleen disorder called splenomegaly should avoid sports to prevent it from rupturing.
In a normal state, rarely do any of us say exactly where the spleen is located - element lymphatic system, performing important role in the function of hematopoiesis, cleansing the blood of destroyed blood elements, participating in the process of bile synthesis and metabolism. An enlargement of this organ (splenomegaly), localized in the abdominal cavity behind the stomach in the left hypochondrium, will immediately force its “owner” to attract attention.
What is the disease
Splenomegaly or enlargement of the spleen is inherently not an independent disease, but a consequence of a number of other ailments. Pathological process involves an increase in the mass of the organ over 600 g, and it can be clearly palpated in the area of the left hypochondrium.
The spleen is located in the left hypochondrium
Splenomegaly has various degrees severity - from moderate (mild or insignificant), which can be observed temporarily, to pronounced, when the organ occupies half of the abdominal space. Most severe forms splenomegaly is observed with oncological lesions of the blood.
The enlargement of the spleen can reach gigantic size An enlarged spleen, in turn, disrupts the normal process of hematopoiesis, i.e., the production of blood elements that accumulate and die in the diseased organ, provoking a condition dangerous to the health and life of the patient, called hypersplenism.
Possible causes of pathology, including giardiasis and blood diseases
Depending on the reasons that caused splenomegaly, the pathology is conventionally divided into the following types:
Moderate splenomegaly may be asymptomatic. When the organ reaches a significant size, the patient may experience:
- bloating;
- feeling of pain and discomfort in the left hypochondrium;
- lack of appetite;
- feeling of quick satiety;
- weight loss;
- weakness, dizziness.
These signs develop due to pressure from the enlarged spleen on the organs of the digestive system. The patient may also have symptoms related to the underlying disease that caused the splenomegaly.
As the organ enlarges, the patient develops sensations of pain and discomfort in the left hypochondrium All about the spleen - video
Diagnosis methods, including ultrasound
First of all, the doctor will analyze the patient’s complaints, conduct an external examination and palpate the spleen area.
A doctor palpates the spleen To clarify the diagnosis and determine the cause of the disease, the following laboratory tests are performed:
- tumor marker tests;
- tests for autoimmune markers;
- spleen puncture;
- CT or MRI provides information about the condition of the organ and the anatomical structures surrounding it;
- radioisotope research provides accurate information about the state of the spleen cells.
Methods of treating the disease
When symptoms of splenomegaly appear, the patient first needs to contact a therapist, who will analyze his condition and refer him to a specialist - hematologist, endocrinologist, oncologist, etc.
Treatment of pathology is aimed at eliminating the underlying disease that causes it. Conservative therapy serves to eliminate infection, reduce pressure in the corresponding veins, fight the oncological process, etc.
In some cases, it is necessary to resort to splenectomy - removal of the spleen. Surgical method treatment is used in the following situations:
Traditional medicine
As already mentioned, splenomegaly is not an independent disease and therefore effective treatment There can only be one that can eliminate the main cause of the pathology. Undoubtedly, folk recipes won't help deal with these serious illnesses, like blood cancer, etc. Moreover, they can be used in parallel with the main treatment to maintain the functioning of the spleen and only after consultation with a doctor. Here are some useful recipes:
- Infusion of shepherd's purse. Brew 15 g of herb with a glass of boiling water, let it brew, strain. Drink a tablespoon 4-5 times a day.
- Hop cone tincture. Pour three large cones or five small ones with a glass of alcohol or strong vodka and let it brew for 10 days in a dark, cool place. Take 40 drops three times a day in a small amount of water.
- Infusion of nettle, strawberry, string and violet leaves. Mix the raw materials in equal proportions, then pour two tablespoons of the mixture into 0.5 liters of boiling water, cover and let it brew until it cools, then strain and take a glass in the morning and evening. People prone to irritation of the mucous membrane of the gastrointestinal tract should exclude nettle from this recipe.
Folk remedies in the treatment of splenomegaly - photo gallery
Shepherd's purse - a remedy for the treatment of splenomegaly 
Hop cones are used for diseases of the spleen 
Nettle has a hemostatic effect 
Strawberries contain many useful substances 
The sequence is valuable medicinal plant 
Remedies from violet flowers are useful for diseases of the spleen
A special diet for splenomegaly is usually not recommended, but it is advisable for the patient to slightly adjust the diet to make it easier for the body to function. To activate the function of hematopoiesis, iron, copper, and vitamin C are needed. Considering the fact that excess sugar has Negative influence on the functioning of the spleen, its use should be limited. In addition, the patient is recommended to eat foods rich in pectin to regulate glucose levels in the body.
So, the patient’s diet should contain:
- dietary meats;
- sea fish, seafood;
- porridge, primarily buckwheat;
- vegetables - cabbage, beets, pumpkin, tomatoes, paprika, etc.;
- fruits and berries, primarily pomegranate, citrus fruits, currants, apples;
- honey (if you are not allergic to it);
- ginger;
- fruit and vegetable juices, berry fruit drinks;
- rosehip decoction;
- green tea.
Products recommended for consumption with splenomegaly - photo gallery
Pomegranate improves the process of hematopoiesis 
Citrus fruits are a source of vitamin C 
Buckwheat is rich in iron 
The patient is recommended to eat dietary meats, including chicken. 
Fruits and vegetables - a supply of microelements and vitamins
Foods that are best excluded from the diet, or at least reduce their consumption:
- alcoholic drinks;
- canned food, smoked meats;
- fatty foods;
- fast food restaurant products;
- confectionery;
- fresh white bread;
- carbonated drinks;
- strong coffee and black tea.
Products not recommended for consumption with splenomegaly - photo gallery
Alcohol negatively affects the liver, which is in close contact with the spleen. 
Black coffee is annoying gastrointestinal tract 
Carbonated waters contain a lot of sugar and harmful impurities and additives. 
Confectionery - excess carbohydrates and glucose 
Smoked meats are a burden on the liver
Features of pathology during pregnancy and in children, including infants and newborns
Women diagnosed with severe splenomegaly are advised to abstain from childbearing until the cause of this condition is eliminated. If the disease is detected on early Pregnancy, doctors may decide to terminate it, and in larger cases, deliver by caesarean section.
Splenomegaly in children is caused by the same reasons as in adults. The peculiarity is that such a diagnosis for a child can be made erroneously. In 35% of newborns, 15% of six-month-old babies and 3–5% junior schoolchildren An enlarged spleen may be noted. This fact is not a sign of disease.
Forecast and prevention of the disease
The prognosis for splenomegaly depends on the disease that causes it. The issue of suitability for military service in the army is also considered in this context.
As for the prevention of splenomegaly, it essentially does not exist. Moreover, a healthy lifestyle, a balanced diet, refusal bad habits and regular examination by a doctor will help reduce the risk of this disease.
Sports are the basis healthy image life Splenomegaly is not an independent disease, and therefore the most important task is the timely identification of the cause that caused the pathology, in order to immediately begin adequate effective treatment.
The spleen is a fist-sized organ located on the left under chest. Because of various diseases it may increase in size, a phenomenon called splenomegaly. What it is, how to treat this disorder - we talk about this in detail in this publication.
Splenomegaly - what is it?
Splenomegaly is an enlargement of the spleen. Pathology can be caused by many reasons and occurs in both adults and children. The spleen plays an important role in fighting infections. Leukocytes are formed in it, which are the first to begin destroying pathogens that have entered the body.
Other functions of the spleen:
- Filtration and destruction of damaged and old blood cells;
- Production of a reserve amount of red blood cells, which are used by the body when necessary, for example, during blood loss;
- Protein synthesis;
- Storage of a supply of blood cells (platelets, erythrocytes, leukocytes);
- Destruction of insoluble compounds resulting from burns.
Splenomegaly is considered as a symptom of a particular disease and is accompanied by a violation of each of these important processes. For example, the spleen begins to filter out not only damaged, but also normal blood cells, which, accumulating in it, interfere with the proper functioning of the organ.
Causes of splenomegaly
There are many diseases that cause splenomegaly. This phenomenon may be temporary, depending on the effectiveness of treatment of the underlying disease. In addition to pathologies of the spleen - tumors, cysts, organ infarctions, abscesses - with splenomegaly the causes may be as follows:
- acute and chronic bacterial infections - brucellosis;
- viral pathologies – hepatitis, rubella, measles;
- mycoses – blastomycosis, histoplasmosis and others fungal infections blood and internal organs;
- protozoal infections – leishmaniasis, ;
- helminthiases – schistosomiasis;
- circulatory disorders - development, Pick's cirrhosis;
- systemic diseases of the hematopoietic organs - leukemia, lymphoma, myelofibrosis;
- pathologies associated with metabolic disorders - glycogenosis, Wilson's disease;
- autoimmune diseases in which the immune system mistakes body cells as foreign - rheumatoid arthritis, systemic lupus erythematosus.
Anemia is also a cause of splenomegaly. different types– pernicious, hemolytic and others.
Splenomegaly in children
IN childhood the spleen is sometimes slightly enlarged without any disturbances in the child’s body. This is physiological norm and is observed in a third of newborns, in 15% six-month-old children and among a small proportion of junior schoolchildren.
The norms for the maximum size of the spleen in children are presented in the table:
| Age, years | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| Width/length, mm | 65/25 | 72/34 | 79/37 | 84/39 | 88/39 | 91/41 | 96/41 |
| 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 |
| 100/43 | 102/43 | 103/44 | 108/44 | 113/45 | 118/46 | 120/48 | 120/49 | 121/51 |
Splenomegaly in children is a symptom of the same diseases as in adults; there are no differences.
There are two forms of splenomegaly:
- Inflammatory, which occurs when organ tissues become inflamed (bacterial, protozoal, viral infections, helminthic infestations, abscesses and heart attack);
- Non-inflammatory, caused by disorders not associated with infections and inflammation (with anemia, systemic, autoimmune diseases).
Moderate splenomegaly is also distinguished when the length of the spleen does not exceed 20 cm, and severe - 21 cm or more.
pain on the left under the ribs - one of the symptoms, photo
Since an enlarged spleen is a manifestation of a particular disease, common symptoms she does not have. There are only signs of splenomegaly associated with its two forms.
1 - manifestations of inflammation:
- high temperature, up to 40°C;
- sharp cutting pain in the left hypochondrium;
- mild nausea;
- sometimes vomiting and diarrhea;
- palpable pain on palpation of the left side under the ribs.
2 - symptoms of splenomegaly without inflammation:
- pulling, aching, unexpressed;
- body temperature remains normal, and if it increases, then to a maximum of 37.5 °C;
- When palpating the side, the pain is not severe.
Diagnosis of splenomegaly
The primary diagnosis of splenomegaly is carried out by palpation of the abdomen in the left hypochondrium. To clarify the diagnosis, the following studies are indicated:
- General clinical blood test to determine the number of leukocytes, red blood cells and platelets;
- Taking liver samples;
- and computed tomography;
- ultrasound examination;
- Bone marrow biopsy, which provides more full information about the state of blood cells.
A puncture biopsy of the spleen is performed extremely rarely, as it carries a risk of bleeding.
Treatment tactics for splenomegaly
Therapy for splenomegaly in adults and children consists of identifying and eliminating the pathology that provoked the enlargement of this organ. Depending on the specific disease, the following drugs are prescribed:
Removal of an enlarged spleen surgically(splenectomy) is indicated if conservative treatment of splenomegaly does not have an effect.
Surgery also necessary for:
- hypersplenism, when healthy blood cells are destroyed in the spleen;
- thrombocytopenic purpura;
- Banti syndrome;
- hemolytic jaundice.
The operation is often performed through laparoscopy - through small incisions. As a result of the removal of the spleen, the body's ability to resist infections is reduced. In this regard, antibiotics are necessary before and after splenectomy. They also vaccinate against meningitis, Haemophilus influenzae, pneumococcal infection and flu.
Complications
TO possible complications splenomegaly includes:
- Hypersplenism is a lack of formed elements in the blood due to their breakdown in the spleen (leukopenia, anemia, thrombocytopenia);
- Organ rupture;
- Worsening of the pathology, against the background of which the spleen was enlarged.
Splenomegaly - which doctor should I contact?
Since the spleen is a hematopoietic organ, its pathologies are treated by a hematologist. But since pain in the left side under the ribs and other manifestations of splenomegaly can be the result of various diseases, you should first make an appointment with a therapist, describing in detail all the symptoms.
After examining and studying the results of basic tests, he will refer you to a more specialized specialist for further diagnosis and treatment.
