Ct and mri may provide more detail of the organs consistency. Hypersplenism is defined as one or more blood cytopenias in the setting of splenomegaly. Although several methods of palpation and percussion of the spleen have been described, until recently they have not been validated by noninvasive imaging techniques such as ultrasonography, radionuclide scanning, and computed tomography that offer objective means to assess splenomegaly. However, it may also refer to an enlarged spleen detected by an imaging test. Cause of splenomegaly is obscurelymphocytic infiltration of splenic liver sinosoids present. Approach to splenomegaly free download as powerpoint presentation.
Presentation of splenomegaly aetiology of splenomegaly. Splenomegaly and hypersplenism free download as powerpoint presentation. Assessing for the presence of splenomegaly is an important component of the physical examination. Classification of splenomegaly hackett 0 spleen not palpable 1 spleen just palpable below lcm, on deep inspiration 2 spleen palpable halfway to umblicus but not beyond it 4 spleen palpable below. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects.
Pdf hypersplenism is a condition in which the spleen becomes increasingly active and then rapidly removes the blood cells. Download pdf version of splenomegaly vs hypersplenism. The spleen is delivered to the midline by means of blunt and sharp dissection of the areolar plane between the kidney and the pancreas. Introduction as early as the 17th century, it was realized that structural changes in the portal circulation could cause gastrointestinal bleeding. Splenomegaly in children see approach to the child with an enlarged spleen.
In the past, splenomegaly was a clinical finding, but in recent years, imaging studies have also helped to assess for or confirm mild splenomegaly. A young woman, with a history of aortic stenosis, was admitted to our unit for a month of intermittent fever associated with a new diastolic heart murmur and splenomegaly. Splenomegaly and hypersplenism information page patient. Splenomegaly hematology and oncology merck manuals. Enlarged spleen india pdf ppt case reports symptoms. Hypothesis the incidence of primary lymphoma of the spleen in patients with idiopathic splenomegaly is significant. Splenomegaly is an enlargement of the spleen resulting from abnormalities of its lymphoid, reticuloendothelial, or vascular components. If confirmation of splenomegaly is necessary because the examination is equivocal, ultrasonography is the test of choice because of its accuracy and low cost. Although splenomegaly is often considered to be an ominous clinical finding, certain normal variants have been found. Full text full text is available as a scanned copy of the original print version. Ppt spleen powerpoint presentation free to view id.
Necessary to specify the age at which there were first signs of the disease hepatosplenomegaly in children is more common than in adults, since early communication elements of a single mononuclear phagocytic system is much stronger, the presence of similar. The hyperreactive malarial splenomegaly syndrome hms is a leading cause of massive splenomegaly in malariaendemic countries. Jan 09, 2018 the most common complaint in patients with splenomegaly is mild, vague, abdominal discomfort. The evaluation of splenomegaly in children and considerations related to elective or traumatic splenectomy are discussed separately.
Surgical indications in idiopathic splenomegaly hematology. Evaluation of splenomegaly differential diagnosis of. Causes of splenomegaly are myriad, as are the many possible ways of classifying them see table common causes of splenomegaly. Splenomegaly may arise as a symptom of a number of diseases, including certain systemic infections, inflammatory diseases, hematologic. With the spleen retracted medially, the phrenicocolic ligament is incised. Tropical splenomegaly massive splenomegaly occurring in people of endemic area for malariakalaazar but no parasite is demonstrable in blood. Splenomegaly general presentation the spleen is a hematopoietic organ supporting the megakaryotic, lymphoid, erythroid, myeloid, and reticuloendothelial systems. Splenomegaly is usually associated with increased workload, which suggests that it is a response to hyperfunction. Anatomy develops from condensations of mesoderm in the dorsal mesogastrium.
Dec 01, 2006 given the positive family history, the smear is indicative of hereditary elliptocytosis he. Hypersplenism is a secondary process that can arise from splenomegaly of almost any cause see table common causes of splenomegaly. The most common complaint in patients with splenomegaly is mild, vague, abdominal discomfort. A free powerpoint ppt presentation displayed as a flash slide show on id.
In 1902, gilbert and carnot introduced the term portal hypertension to describe this condition. Patients may also experience pain,which may be referred to the left shoulder. Splenomegaly american academy of pediatrics textbook of. The spleen usually lies in the left upper quadrant luq of the human abdomen. Given the positive family history, the smear is indicative of hereditary elliptocytosis he. The term splenomegaly generally denotes a palpably enlarged spleen. Get a printable copy pdf file of the complete article 932k, or click on a page image below to browse page by page. Fever of unknown origin fuo can be determined by different conditions among which infectious diseases represent the main cause patient concerns.
Early satiety from gastric displacement occurs with massive splenomegaly. Classic fakunles major criteria for case definition are. At a routine followup appointment, her local pediatrician noted splenomegaly but no hepatomegaly and rereferred her to the geneticist. This topic provides an overview of normal splenic size and function and an approach to evaluating splenic abnormalities in adults.
Anatomic descriptions of the spleen are found in the works of aristotle, hippocrates, in the talmud and the bible 1, but its function has only been investigated and understood in the last hundred years. Enlarged spleen mexico pdf ppt case reports symptoms. Other functions include filtering senescent and defective red blood cells, presenting antigens to the immune system, and destroying. It is a reservoir for platelets and a site for the proliferation of blymphocytes. Anemia and splenomegaly blood american society of hematology. But approximately 10% have a mild degree of anemia and splenomegaly. Hypersplenism is a syndrome characterized by splenomegaly and any or all of the following cytopenias. Implicit in the definition is that the cytopenias will correct after splenectomy. In normal individuals or in patients with mild splenomegaly, the spleen generally retains its usual tetrahedral shape and there appears to be a good cor relation between measurements whether by mr, ct or ultrasound 1. Ppt splenomegaly powerpoint presentation free to view. Any other suspicious site if the result of the biopsy would change therapy. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience. Hms is caused by a chronic antigenic stimulation derived from the malaria parasite.
Immune hemolytic anemia is classified as autoimmune, alloimmune, or druginduced, based on the antigen that stimulates antibody or complementmediated destruction of red blood cells. Splenomegaly, hypersplenism, and hereditary disorders with. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly free download as powerpoint presentation. Splenomegaly increases the spleens mechanical filtering and destruction of red blood cells rbcs and often of white blood cells wbcs and platelets. Necessary to specify the age at which there were first signs of the disease hepatosplenomegaly in children is more common than in adults, since early communication elements of a single mononuclear phagocytic system is much stronger, the presence. Splenomegaly can occur as a result of vascular engorgement or cellular infiltration, and it is frequently associated with a combination of neutropenia, thrombocytopenia, and anemia. Hepatosplenomegaly hpm is a disorder where both the liver and spleen swell beyond their normal size, due to one of a number of causes. It enlarges towards the right iliac fossa rif always start palpation in the rif and move across towards the right upper quadrant or a massive splenomegaly may be missed. Splenomegaly is one of the four cardinal signs of hypersplenism which include.
Splenomegaly can be found in 3% of the normal population. Splenomegaly is defined as enlargement of the spleen, measured by size or weight. Although splenomegaly is almost always present in hypersplenism, many patients with splenomegaly do not have hypersplenism. Diagnostic algorithm is based on a thorough observation of data from medical history and patient complaints and physical examination. Most patients are not anemic because of a compensated hemolytic anemia. Splenomegaly causes of splenomegaly portal hypertension 33% chronic liver disease portalsplenic venous obstruction. Splenomegaly is a feature of a broad range of diseases, and presents to clinicians in many. In some patients, extensive radiological and laboratory investigations. Splenomegaly and hypersplenism lymphatic system medical. Further investigation and management of splenomegaly depends on cause but can include ct abdomenpelvis bone marrow aspirate and trephine lymph node biopsy full liver screen common questions concerning splenomegaly what are the causes of splenomegaly by size of splenic en largement. An ultrasound examination confirmed the splenomegaly with slight enlargement of the liver but which did not meet criteria for hepatomegaly. Splenomegaly, enlargement of the spleen, the abdominal organ that serves as a temporary storage site for blood and filters out degenerated and old blood cells.
The spleen has long been a mysterious organ whose function was unknown. The difference between splenomegaly and hypersplenism depends on the nature of the abnormality. Tuberculous splenomegaly with gi bleeding due to portal htn failure of percutaneous drainage of splenic abscess multiple abscesses of the spleen ps continue att after surgery indications 2,6. Igm antibodies against malaria are detected in blood. The spleen is a functionally diverse organ with active roles in immunosurveillance and hematopoiesis.
Jul 21, 2017 the difference between splenomegaly and hypersplenism depends on the nature of the abnormality. On the other hand, as the spleen progressively and. Splenomegaly is an exception rather than the rule, and the hematologic profile is that of selective absence or reduction in the number of neutrophils, while monocytes, eosinophils, and basophils are either normal or increased. Spleen is an organ located just below your rib cage on your left side. Mri is especially useful in detecting portal or splenic vein thromboses. Difference between hypersplenism and splenomegaly compare. Approach to splenomegaly authorstream presentation. Splenomegaly is almost always secondary to other disorders. When considering whether an luq mass is an enlarged spleen, features of an enlarged spleen include that. An overzealous palpation of the abdomen or a sudden blow can split the outer capsule of the spleen and cause bleeding into the abdominal cavity. A person with splenomegaly should take care to avoid all contact sports and any other activities that could potentially deliver a hard impact to their abdomen. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly. Classification of splenomegaly hackett 0 spleen not palpable 1 spleen just palpable below lcm, on deep inspiration 2 spleen palpable halfway to umblicus but not beyond it 4 spleen palpable below umblicus but not below horizontal. Splenomegaly is abnormal enlargement of the spleen.
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