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    Splenomegaly 180319023541

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    Mohd Shoaib
    This document defines splenomegaly as an enlarged spleen and classifies it as mild, moderate, or massive based on size. It lists various causes of splenomegaly including infections, cirrhosis, and infiltrative diseases. Symptoms are related to the underlying condition and diagnosis involves blood tests, imaging like ultrasound or CT. Management depends on the severity but may involve observation or splenectomy.

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    Splenomegaly 180319023541

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    Mohd Shoaib
    127 views21 pages
    This document defines splenomegaly as an enlarged spleen and classifies it as mild, moderate, or massive based on size. It lists various causes of splenomegaly including infections, cirrhosis, and infiltrative diseases. Symptoms are related to the underlying condition and diagnosis involves blood tests, imaging like ultrasound or CT. Management depends on the severity but may involve observation or splenectomy.

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    This document defines splenomegaly as an enlarged spleen and classifies it as mild, moderate, or massive based on size. It lists various causes of splenomegaly including infections, cirrhosis, and infiltrative diseases. Symptoms are related to the underlying condition and diagnosis involves blood tests, imaging like ultrasound or CT. Management depends on the severity but may involve observation or splenectomy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    127 views21 pages

    Splenomegaly 180319023541

    Uploaded by

    Mohd Shoaib
    This document defines splenomegaly as an enlarged spleen and classifies it as mild, moderate, or massive based on size. It lists various causes of splenomegaly including infections, cirrhosis, and infiltrative diseases. Symptoms are related to the underlying condition and diagnosis involves blood tests, imaging like ultrasound or CT. Management depends on the severity but may involve observation or splenectomy.

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     Splenomegaly

    Definition
    Classification
    Etiology
    Symptom
    Diagnosis
    References
    Splenomegaly is defined by increased splenic
    dimensions and volume.

    Spleen diameters averaged over 13 cm and an area


    above 45 cm2 or weight above 400 g are considered
    splenomegaly.
    Normal Spleen Splenomegaly
    Splenomegaly can be classify as;
    Mild
    Moderate
    Massive
    Mild Splenomegaly
     Just palpable

     (1-3) cm more than normal


    spleen ≈ 14cm - 16 cm

     Spleen > 400 g < 1000 g

    Mild Splenomegaly with Cirrhosis


    Moderate Splenomegaly
    Between costal margin & umbilicus

     (4-8) cm more than normal spleen ≈ 17 cm – 21 cm

    Spleen > 400 g <1000 g

    Splenic Area 45 cm2 -65 cm2


    Massive Splenomegaly
     Beyond umblicus, crosses mid line into pelvis

     Spleen > 8cm than normal

     Spleen > 1000g

     Splenic area > 65 cm2


    Splenomegaly (Splenic Length) Age Group
    >6.0 cm 3 months
    >6.5 cm 6 months
    >7.0 cm 12 months
    >8.0 cm 2 years
    >9.0 cm 4 years
    >9.5 cm 6 years
    >10.0 cm 8 years
    >11.0 cm 10 years
    >11.5 cm 12 years
    >12.0 cm 15 years
    Splenomegaly due to exaggerated forms of normal splenic function;
    - infections or inflammatory processes results from an increase in the
    defense activities of the organ

    - Removal of abnormal blood cells from the circulation is the usual


    source of hyperplastic splenomegaly.

    - Cirrhosis with portal hypertension, splenic vein occlusion or


    congestive heart failure (CHF) causes congestive splenomegaly

    - Infiltrative splenomegaly is the result of swelling of macrophages


    with indigestible materials.
    Cysts,
    Hemangiomas,
    Other malformations.

    Several diseases can lead to splenomegaly; malaria,


    anemias etc.
    Associated symptoms or signs are typically related to the underlying
    disorder.
     Fever
     Left Upper Quadrant pain (splenic infarct) (localize area of dead cell)
     Fullness and early satiety
     Feeling of heaviness in LUQ
     Jaundice
    Most practical and cost effective method

    Perform a complete blood count (CBC) with differential, platelet count,


    and peripheral blood smear

     Computed Tomography
     Magnetic Resonance Imaging,
     Ultrasonography (High sensitivity & specificity, safe, noninvasive, quick, mobile, and
    less costly)
     Splenic Dimensions
     Splenic Contour (Rounded Edge)
     Dilated Splenic vein (> 9 mm)

    - Homogenous, slightly hyperechoic, with mild-


    to-low echogenicity compare to liver, a smooth contour.
    Massive Splenomegaly
    Mild irregular contour and inhomogeneous echo-structure with diffuse hyperechoic foci
    suggesting small infarctions
    Splenomegaly with Splenic Vein Dilation
     If the spleen is minimally enlarged, may be followed with careful
    and regular observation.

     Patients with enlarged spleens are more likely to have splenic


    rupture from blunt abdominal or low thoracic trauma.

     Splenomegaly most likely result in splenectomy


     Swaoop J, O’Reily RA. Splenomegaly at a University Hospital
    compared to a nearby county hospital in 317 patients. Acta
    Haematol 1999;102:83-8.
     Ioanitescu S, Iliescu L, Harza M, Ismail G, Copaci I. Ultrasound of
    the spleen, EFSUMB Course Book;1-46. Published by EFSUMB,
    2012.
     Radhakrishnan N, Besa,C, E. Splenomegaly. Medscape. 2018
    January 09;1-9
     World Health Organisation, World Federation for Ultrasound in
    Medicine and Biology: Manual of Diagnostic ultrasound; 2003

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