Your spleen is rock-hard and fist-sized. Your spleen lies in the upper left part of your body between your stomach and ribcage. It filters bacteria from your blood and destroys old or damaged cells so they can be reused. An enlarged spleen is referred to as splenomegaly. Asymptomatic splenomegaly in the majority of cases more typical a result of prodromal presentation lethal underlying disease and illness like infection, liver disease, and malignancy hematologic. Either Chronic splenomegaly caused, child patient, or secondary to hematology disease, or liver disease, emergent diagnosis must be established.

What is Enlarged Spleen (Splenomegaly)?

Splenomegaly means enlargement of the spleen. Spleen is typically 11 cm in size and has a weight of 150 grams. It even goes down below the ribcage and reaches as low as the lower abdomen during development. The enlarged spleen also works harder at breaking down surplus blood cells, a condition of hypersplenism.
Spleen most crucial roles:

  • Removal of old red blood cells and microorganisms
  • Synthesis and storage of white blood cells and platelets
  • Maintenance of immune response
Enlargement is secondary to a root cause and not the primary cause, and the cause thereof is thus needed to be determined in order to treat the condition accordingly.

Causes of Splenomegaly

There are many causes of splenomegaly. Infection, system disease, and some congenital disease are the most common causes.

Infections

  • Bacterial infections: e.g., syphilis, tuberculosis, and endocarditis.
  • Infectious disease: Most commonly Epstein-Barr virus (mononucleosis), a common cause of young adult splenomegaly.
  • Parasitic disease: Schistosomiasis and malaria are common culprits, especially in endemic populations.

Liver Illness

Liver illness like cirrhosis leads to portal hypertension, and blood has to be driven into the spleen. It is a common example of Splenomegaly liver disease where both organs get affected due to the vascular relationship between the two organs.

Diseases of the Blood

Leukemia, lymphoma, thalassemia, and hemolytic anemia are the diseases that lead to the increase in work of the spleen in order to achieve and thus Splenomegaly blood disorders.

Metabolic and Genetic Diseases

Gaucher's disease, Niemann-Pick disease, and amyloidosis are diseases that lead to splenomegaly. They would prefer to occur in children and lead to splenomegaly.

Autoimmune Diseases

Systemic lupus erythematosus and rheumatoid arthritis are among a few of the causes of spleen enlargement due to system immune hyperactivity.

Cancer

Two of the common reasons for spleen enlargement with blood and lymph cancers are Hodgkin's lymphoma or non-Hodgkin's lymphoma.

Different Symptoms of Splenomegaly

Splenomegaly signs and symptoms are extremely varied and are determined by the causes of splenomegaly as well as by the degree of enlargement of the spleen. In most patients with mild splenomegaly, the patients are asymptomatic, and splenomegaly is detected incidentally on imaging or physical examination done for some other reason.
On the occurrence of presenting signs, these are caused by pressure and symptoms caused by an enlarged spleen:

  • Pain or tightness upper left quadrant, referred to left shoulder
  • Satiation premature due to compression of stomach
  • Weakness and fatigue
  • Over-infection due to immunocompromised status
  • Bruising or bleeding easily due to thrombocytopenia
  • Weight loss or fever, especially due to malignancy or infection
An inflamed belly, irritability, or anorexia might be familiar to parents in the Splenomegaly in children.


What Is Involved with Diagnosing Splenomegaly?

Diagnosis is first established by physical examination when one can feel with the fingers an enlarged spleen. Diagnosis still has to actually diagnose and ascertain the cause of it occurring.

Imaging Tests

  • Ultrasound splenetic usually is the initial imaging test that is performed. It examines the size of the spleen and identifies defects.
  • CT and MRI are employed only for taking good pictures, particularly in those suspected to have cysts or tumors.

Blood Tests

  • Complete Blood Count (CBC): To quantify the white cells, red cells, and platelets.
  • Liver Function Tests (LFTs): To check the liver's function as well as the causation of liver disease splenomegaly.
To screen for infection caused by Epstein-Barr virus, HIV, malaria, or tuberculosis.

Bone Marrow Examination

In suspicion of bone marrow cancer or blood disease, then the bone marrow biopsy would be the choice.

Genetic or Metabolic Testing

They are usually performed in the case of suspicion of occurrence of a genetic metabolic disorder, most commonly in children.

What Are Complications of Splenomegaly?

An enlarged spleen has numerous complications, particularly if untreated.

Hypersplenism

  • The spleen begins to destroy excess blood cells, and this leads to:
  • Anemia
  • Low platelets (thrombocytopenia)
  • Low white cells (leukopenia)

Spleen Rupture

Spleen ruptures more easily when enlarged, especially after trauma. This will result in bleeding heavy enough to necessitate emergency operation.

Immune Dysfunction

Regardless of spleen resection or otherwise, immune dysfunction will compromise immunity. This is the patient who after splenectomy loses spleen function permanently.

Some Therapeutic Techniques in Splenomegaly

Treatment of splenomegaly depends on etiologic etiology. Spleen size in some disease can be reduced by treatment of the disease.

Medication Therapy

  • Antibiotics in bacterial etiology
  • Antiviral therapy in viral etiology like mononucleosis
  • Antimalarial therapy in parasitic etiology
  • Immunosuppression or corticosteroids in autoimmune disease

Treatment of the Primary Disease

Pathologic conditions like cirrhosis, leukemia or lymphoma can cause splenomegaly to reduce after successful treatment. Transfusion, chemotherapy, and bone marrow transplant are disease-related.

Surgery (Splenectomy)

Splenectomy would be done for spontaneous or impending rupture of the spleen. It carries the additional lifetime risk of infection, and the patients are most commonly immunized with pneumococcus, meningococcus, and Haemophilus influenzae.

Observation

Where the splenomegaly is not of ill, nor complicated, nor asymptomatic nature, physicians will rather observe the patient closely without doing anything.

Conclusion

Splenomegaly is a condition which will have to be screened round the clock as it can be an indicator of serious underlying medical complications. Regardless of causes of the underlying one being infection, liver disease, or hematologic disorders, an enlarged spleen should never be underestimated.

Diagnostic procedures like splenomegaly ultrasound and hematologic work-ups are part of its diagnosis for determining its etiology. In all of these, with appropriate and timely diagnosis and treatment from drug to way beyond on the surgical side, they are all okay, even cure the disease. Longitudinal follow-up and care on a daily basis have a lot to do with avoiding such complications like rupture or hypersplenism.

Please book an appointment with the Best Hematologist in Lahore, Karachi, Islamabad, and all major cities of Pakistan through InstaCare, or call our helpline at 03171777509 to find a verified doctor for your disease.