Splenic enlargement (or splenomegaly) is caused by many diseases. The main ones are chronic infections and cancer.
The spleen is a small organ on the left side of the abdomen under the chest. The spleen is the size of a fist and supports some functions of the human body.
Causes of enlargement of the spleen
Many diseases affect the functionality of the spleen and cause swelling. The causes of liver and spleen enlargement are classified into different groups:
- Infections (brucellosis (1), endocarditis (2), hepatitis B or C, HIV, etc.)
- Cancer (leukemia, lymphoma or pancreatic tumor)
- Amyloidosis (5)
- Sarcoidosis (6)
- Anemia or thalassemia
The infections are divided into:
- viral infections (mononucleosis),
- parasitic infections (malaria (7)),
- bacterial infections (syphilis (8)).
The secondary swelling of the spleen occurs during an infection as a defense mechanism of the body to fight the pathogenic pathogen.
Some types of tumors, such as leukemia and Hodgkin’s disease, are diagnosed when the first symptoms of the spleen appear.
Any type of cancer that spreads in the spleen can damage it and cause swelling.
The premature destruction of red blood cells by anemia enlarges the spleen.
There are some metabolic disorders, such as Gaucher disease, Niemann-Pick disease, and Hurler syndrome, that cause splenic enlargement.
An obstacle to flow can lead to swelling of this organ.
In people who suffer from congestive heart failure, the pressure on the splenic vein is high.
This leads to an increase in the size of the liver and spleen.
Some inflammatory diseases like rheumatoid arthritis and sarcoidosis cause an enlargement of the spleen.
Mechanical injuries to this organ lead to enlargement of the spleen.
Symptoms of enlargement of the spleen
Spleen enlargement need not always be a concern.
The following main symptoms result:
- Pain in the left flank radiating to the abdomen and back
- Bloating, only in children
- Inexplicable weight loss
- Common infections
- Anemia (low red blood cells)
- High fever in infection or intermittent fever when the patient has mononucleosis; this symptom also exists in cirrhosis, leukemia and thrombotic thrombocytopenic purpura
- Frequent bleeding
- Fatigue, inexplicable tiredness
Splenic enlargement in children
Splenic enlargement in children is caused by:
- Mediterranean anemia or microcythemia,
- cancer,
- other infections.
Diagnosis of splenic enlargement
Doctors can easily diagnose splenic enlargement in children.
A doctor suspects that there is a problem with this organ if the patient complains of a feeling of fullness in the stomach without having eaten anything.
The doctor palpates the size of the spleen at palpation in the upper left region of the abdomen. To confirm an existing splenomegaly (enlargement of the spleen), doctors order in-depth diagnostics (examination):
High transaminases, high blood cell counts (BKS) and enlargement of the spleen indicate one mononucleosis down.
With mononucleosis and anemia you can see, that indirect bilirubin is also increased.
If the doctor suspects cancer such as leukemia or lymphoma, he can order a bone marrow sample to analyze the cells.
- X-ray photograph
- CT
- echographie
- Magnetic resonance imaging (shows the course of blood flow in the spleen)
The images are studied to determine the increase in spleen size.
Enlargement of the spleen or splenomegaly
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When do you have to worry?
A blood test is taken from the patient to determine the number of red and white blood cells and platelets.
- At a leukemia the white blood cells are high, but red blood cells and platelets are low.
- In hypersplenic syndrome and Gaucher disease blood tests show decreased white and red blood cells and a lack of platelets (thrombocytopenia).