SYMPTOMS

What is Splenomegaly?

The spleen is the largest lymphatic organ in the human body, located in the upper left abdomen. A healthy spleen weighs approximately 150–200 grams, appears dark red, and has a firm texture. Normally, the spleen cannot be felt through the body surface, but if it becomes palpable when lying on one's back or right side, it may indicate splenomegaly. The size of the spleen can usually be confirmed via ultrasound.

Splenomegaly itself is not a disease but rather a result of an underlying condition. Many diseases can lead to an enlarged spleen. To determine the cause, doctors must consider a range of conditions, from chronic infections to hematologic malignancies.

Splenomegaly is typically classified into three degrees:

• Mild enlargement: The spleen edge does not extend more than 2 cm below the rib margin.
• Moderate enlargement: The spleen edge extends more than 2 cm below the rib margin but remains above the umbilical level.
• Severe enlargement (massive splenomegaly): The spleen edge extends beyond the umbilical level or the midline of the abdomen.

TREATMENT

How to Improve Splenomegaly?

• Dress appropriately for the weather to keep warm. Under a doctor's guidance, take vitamin C to boost immunity and reduce the risk of colds.

• Ensure adequate protein intake by eating lean meat, eggs, dairy products, and soy products.

• Consume iron-rich foods like animal liver, blood, lean meat, fruits, and vegetables to support blood production and prevent anemia.

• Reduce liver burden by minimizing medication, avoiding processed meats like ham, sausages, and cured meats, and abstaining from alcohol. Ensure sufficient sleep daily and engage in moderate exercise to strengthen overall health.

Note: If these measures do not alleviate splenomegaly, seek medical attention promptly to identify the underlying cause and receive targeted treatment.

DIAGNOSIS

When to Seek Medical Attention for Splenomegaly?

Splenomegaly can be caused by various conditions, including cirrhosis, malaria sequelae, chronic lymphocytic leukemia, chronic hemolytic jaundice, lymphoma, systemic lupus erythematosus, and other benign or malignant diseases.

When splenomegaly occurs, the underlying cause must be identified based on the patient's other symptoms. Immediate medical attention and hospitalization are required if severe complications arise, such as:

• Portal vein thrombosis or embolism;

• Severe hemolytic anemia, bleeding, or infection;

• Pale complexion, rapid and thready pulse, or narrowed pulse pressure;

• Oliguria or anuria;

• Lethargy, dulled senses, cold extremities, or restlessness.

POTENTIAL DISEASES

What are the possible causes of splenomegaly?

• Infectious splenomegaly:

  • Acute infectious splenomegaly caused by viral hepatitis, sepsis, etc.: Generally mild in degree and soft in texture, the spleen gradually shrinks as the infection is controlled.
  • Splenic abscess: A rare complication of abdominal pyogenic infections, pyemia, typhoid fever, etc., characterized by chills, fever, abdominal muscle tension, splenomegaly with tenderness and fluctuation, and elevated white blood cells.

• Congestive splenomegaly: Caused by portal hypertension, seen in various types of cirrhosis, as well as portal vein or splenic vein inflammation or thrombosis, often accompanied by hypersplenism in advanced stages.

• Hematologic splenomegaly:

  • Chronic leukemia, myelofibrosis, and chronic hemolytic anemia often present with significant splenomegaly.

  • Chronic primary thrombocytopenic purpura, of unknown etiology, commonly occurs in young women, characterized by skin and mucosal bleeding, thrombocytopenia, prolonged bleeding time, normal coagulation time, increased megakaryocytes in the bone marrow, and impaired platelet formation, often accompanied by mild splenomegaly.

• Reticuloendothelial cell disease-related splenomegaly: Clinically rare, such as eosinophilic granuloma and malignant histiocytoma.

• Neoplastic splenomegaly: Includes primary splenic tumors and splenic cysts.