Explanation of what splenomegaly is in relation to its dimension deviation from normal spleen.Classification of splenomegaly according to it's size in adult and pediatric. The causes of splenomegaly along with the symptom that would manifest as a result of this anomaly. Lastly, diagnosis of splenomegaly
4. 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.
7. Mild Splenomegaly
Just palpable
(1-3) cm more than normal
spleen ≈ 14cm - 16 cm
Spleen > 400 g < 1000 g
Mild Splenomegaly with Cirrhosis
8. 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
11. 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
12. 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.
14. 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
15. 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)
16. 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.
20. 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
21. 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