Surgical Conditions  

Splenomegaly

Spleen enlargement; Enlarged spleen

Splenomegaly is an enlargement of the spleen beyond its normal size. Hepatosplenomegaly is the enlargement of both the liver and the spleen.

The spleen is an organ involved in the production and maintenance of red blood cells,
the production of certain circulating white blood cells, and is a part of the lymph system
and the immune system. It also has a phagocytic role and acts as a filter for circulating
microorganisms, old and deformed red cells, and other antigens.

Because of its wide variety of functions, the spleen may be affected by many conditions involving the blood or lymph system, and by infection, malignancies, liver disease and parasites.

Causes  

The liver is involved in a multitude of bodily functions, and is affected by a variety of conditions, many of which result in hepatomegaly.

Infection
   a. Viral- EBV. CMV, Parvovirus 19, HIV
   b. Bacterial- Typhoid fever, SBE, Septicemia, Cat Scratch, TB
   c. Protozoal- Malaria
   d. Fungal- Histoplasmosis, Coccidiodmycosis
Haematological Disorders
   a. Haemolytic disorders- autoimmune, red cell membrane defects including        spherocytosis, elliptocytosis. G6PD, pyruvate kinase deficiency
   b. Haemoglobinopathies- Sickle cell syndromes, thalassemia syndromes
   c. Extramedullary haematopoiesis- Thalassemia and osteopetrosis
Splenic infiltration
   a. Gaucher's and Niemann-Pick
   b. Leukemic infiltration,
   c. Hodgkin's disease
Lupus, JRA, Sarcoidosis
Trauma
Splenic cysts, hemangiomas,
Disorders of Splenic blood flow -
   a. Cavernous transformation of the portal vein
   b. Hepatic cirrhosis
   c. Portal and/or splenic vein thrombosis

Diagnosis  

Diagnosing splenomegaly involves a number of tests, including:

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

 

Depending on the cause


Obesity
Hernias
Gall Stones
Reflux Disease
Liver surgery
Lap Band Surgery
Laparoscopic Surgery
Cancer
 
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