Splenomegaly

Answer 1

Definition

Splenomegaly is an enlargement of the spleen beyond its normal size.

Alternative Names

Spleen enlargement; Enlarged spleen

Considerations

The spleen is an organ that is a part of the lymph system. It filters the blood and maintains healthy red and white blood cells and platelets.

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

Symptoms of splenomegaly include:

• Hiccups
• Inability to eat a large meal
• Pain on the upper left side of the abdomen

Common Causes

• Infections
  • Bacterial infections
  • Cat scratch disease
  • Infectious mononucleosis (Epstein-Barr Virus or Cytomegalovirus)
  • Other viral infections
  • Parasitic infections
• Diseases involving the liver
  • Biliary atresia
  • Cirrhosis(alcoholic cirrhosis)
  • Cystic fibrosis
  • Portal hypertension
  • Portal vein obstruction
  • Sclerosing cholangitis
• Blood diseases
  • Hemoglobinopathies
  • Hemolytic anemia due to G6PD deficiency
  • Idiopathic autoimmune hemolytic anemia
  • Immune hemolytic anemia
  • Myelodysplastic syndrome
  • Polycythemia vera
  • Thalassemia
• Cancer
• Hodgkin's disease
• Leukemia
• Lymphoma
• Other causes
• Felty syndrome
• Lupus (systemic lupus erythematosus)
• Sarcoidosis
• Sickle cell splenic crisis

Home Care

Appropriate limitation of activity, including avoiding contact sports, will help prevent trauma that might cause the spleen to rupture.

Care will be required for the specific condition causing the splenomegaly. Follow the instructions given by your health care provider regarding appropriate care.

Call your health care provider if

Although there are usually no symptoms from an enlarged spleen, you may experience pain in the left upper section of your abdomen. You should seek attention from your doctor right away if it is severe or gets worse when you take a deep breath.

What to expect at your health care provider's office

The physician will ask a series of questions to determine if you have symptoms either from the enlarged spleen or the underlying cause of the large spleen, such as fever or signs of an infectious disease.

The doctor will also perform a thorough exam of your abdomen. To check for an enlarged spleen, he or she will tap (percuss) along the left upper portion of your abdomen and feel (palpate) in that same area, especially just under the rib cage.

Diagnostic tests may be required, including:

• Abdominal x-ray, ultrasound, or CT scan
• Blood tests such as a CBC and tests of your liver function
• Tests for suspected causes of splenomegaly

References

Armitage J. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 174.

Answer 2

Definition

Splenomegaly is an enlargement of the spleen beyond its normal size.

Alternative Names

Spleen enlargement; Enlarged spleen

Considerations

The spleen is an organ that is a part of the lymph system. It filters the blood and maintains healthy red and white blood cells and platelets.

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

Symptoms of splenomegaly include:

• Hiccups
• Inability to eat a large meal
• Pain on the upper left side of the abdomen

Common Causes

• Infections
  • Bacterial infections
  • Cat scratch disease
  • Infectious mononucleosis (Epstein-Barr Virus or Cytomegalovirus)
  • Other viral infections
  • Parasitic infections
• Diseases involving the liver
  • Biliary atresia
  • Cirrhosis(alcoholic cirrhosis)
  • Cystic fibrosis
  • Portal hypertension
  • Portal vein obstruction
  • Sclerosing cholangitis
• Blood diseases
  • Hemoglobinopathies
  • Hemolytic anemia due to G6PD deficiency
  • Idiopathic autoimmune hemolytic anemia
  • Immune hemolytic anemia
  • Myelodysplastic syndrome
  • Polycythemia vera
  • Thalassemia
• Cancer
• Hodgkin's disease
• Leukemia
• Lymphoma
• Other causes
• Felty syndrome
• Lupus (systemic lupus erythematosus)
• Sarcoidosis
• Sickle cell splenic crisis

Home Care

Appropriate limitation of activity, including avoiding contact sports, will help prevent trauma that might cause the spleen to rupture.

Care will be required for the specific condition causing the splenomegaly. Follow the instructions given by your health care provider regarding appropriate care.

Call your health care provider if

Although there are usually no symptoms from an enlarged spleen, you may experience pain in the left upper section of your abdomen. You should seek attention from your doctor right away if it is severe or gets worse when you take a deep breath.

What to expect at your health care provider's office

The physician will ask a series of questions to determine if you have symptoms either from the enlarged spleen or the underlying cause of the large spleen, such as fever or signs of an infectious disease.

The doctor will also perform a thorough exam of your abdomen. To check for an enlarged spleen, he or she will tap (percuss) along the left upper portion of your abdomen and feel (palpate) in that same area, especially just under the rib cage.

Diagnostic tests may be required, including:

• Abdominal x-ray, ultrasound, or CT scan
• Blood tests such as a CBC and tests of your liver function
• Tests for suspected causes of splenomegaly

References

Armitage J. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 174.

Reviewed By

Review Date: 02/09/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.