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Splenomegaly 180319023541

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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Mohd Shoaib
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293 views21 pages

Splenomegaly 180319023541

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.

Uploaded by

Mohd Shoaib
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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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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