splenomegaly
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Introduction
Enlargement of the spleen.
Etiology
- massive splenomegaly
- other causes
- also see causes of splenomegaly
Pathology
- dilutional effect from expansion of plasma volume that accompanies splenomegaly
- pooling of cells in spleen
- serious bleeding or infectious complications are rare
- splenomegaly itself does not cause increased destruction of normal cells
Clinical manifestations
- dullness to percussion in Traube's space
- may be painful
- early satiety with massive splenomegaly
Laboratory
- complete blood count (CBC) with peripheral smear
- mild to moderate pancytopenia
- platelet count is affected most
- mild to moderate pancytopenia
- bone marrow aspiration & biopsy
- chemistry panel
* HgbA1c may be diminished if erythrocyte survival is reduced
Diagnostic procedures
- upper GI endoscopy to evaluate for esophageal varices if suspicion of portal hypertension & cirrhosis & in the context of alcohol abuse[5]
Radiology
- computed tomography to evaluate anatomy of spleen[4]
- ultrasound with doppler to evaluate flow through portal & splenic vein
- technetium liver-spleen scan
- in chronic liver disease there is a redistribution of technetium from the liver to the bone marrow & spleen
Complications
Management
- splenectomy
- diagnosis if other diagnostic measures do not provide diagnosis
- therapeutic
More general terms
More specific terms
Additional terms
References
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 45
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 350
- ↑ 4.0 4.1 Veterans Administration, Dept of Radiology
- ↑ 5.0 5.1 Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2017;65:310-335. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27786365