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Tuesday, February 17, 2009

Splenomegaly - Lesson 52

WHAT IS SPLENOMEGALY MEANS?  The spleen is an organ in the left upper quadrant of the abdomen (below the diaphragm and to the side of the stomach). It is composed of lymph tissue and blood vessels. Its job is to dispose of dying red blood cells and manufacture white blood cells (lymphocytes) to fight disease. If the spleen must be removed (splenectomy) other organs carry out these functions.

Splenomegaly is an enlargement of the spleen, which usually occurs in the left upper quadrant (LUQ) of the human abdomen. The four most reasons for this condition are hypersplenism, and cytopenia(s), normal or hyperplastic bone marrow, and also may be the response to a splenectomy.

Splenomegaly is generally associated with hemolytic anemias, which suggests that it is a response to hyperfunction. Splenomegaly is associated with any disease process that involves abnormal red blood cells being destroyed in the spleen.

Other common causes include congestion due to portal hypertension and infiltration by leukemias and lymphomas. Thus, the finding of an enlarged spleen; along with caput medusa; is an important sign of portal hypertension.

SYMPTOMS OF SPLENOMEGALY:

Symptoms of splenomegaly may include abdominal pain, early satiety due to splenic encroachment, or the symptoms of anemia due to associating cytopenia.

Signs of splenomegaly may include a palpable left upper quadrant abdominal mass or splenic rub. Splenomegaly can be detected on physical examination by using Castell's sign or Traube's space, but an ultrasound can be used to confirm diagnosis.

TREATMENT FOR SPLENECTOMY:

If the splenomegaly is due to the hypersplenism, a splenectomy is recommended to rectify the problem. After splenectomy, probably, the patients are prone to infectious diseases. So after splenectomy, patients should be vaccinated against Haemophilus influenzae and Streptococcus pneumoniae. They should receive annual influenza vaccinations. Long-term prophylactic antibiotics should be given.
In the next post, we will learn about SYMBIOSIS...Ok
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