Splenomegaly Flashcards
What is splenomegaly?
Enlargement of the spleen
The spleen is located in the left upper quadrant of the abdomen.
What are the common symptoms of splenomegaly?
Three common symptoms:
* Abdominal bloating
* Vague abdominal discomfort
* Early satiety
How does abdominal pain present in splenomegaly?
Usually presents with abdominal bloating and vague discomfort around the upper left side of the stomach
Pain can radiate to pleuritic pain and referred pain in the left shoulder.
What symptom worsens when a patient takes a deep breath in splenomegaly?
Stomach pain
This occurs due to the enlarged spleen pressing on surrounding structures.
What is early satiety in the context of splenomegaly?
Inability to eat a large meal due to feeling full after eating a small amount
This occurs as the spleen presses on the stomach.
What physical exam finding is noted in splenomegaly?
A mass in the left upper quadrant of the abdomen that moves down and medially with respiration
It is dull on percussion during inspiration but not during expiration.
What hematological conditions can arise from splenomegaly?
Thrombocytopenia and anemia
Patients can bleed and bruise easily due to low platelet count.
What could increased infections in a splenomegaly patient indicate?
Leukopenia, such as neutropenia
This refers to a low white blood cell count.
What is pancytopenia?
A reduction in red blood cells, white blood cells, and platelets
This condition can be associated with splenomegaly.
What initial investigations are conducted for splenomegaly?
FBC, ESR, blood film, LFTs, U&Es
These tests help assess blood counts and liver function.
What are haematological causes of splenomegaly?
Leukaemia, Lymphoma, Haemolytic anaemia, Myelofibrosis, Haemangioma, Iron-deficiency anaemia, pernicious anaemia, Thalassaemia.
What is myelofibrosis?
A myeloproliferative disorder causing bone marrow abnormality, leading to erythropoiesis in other body parts like the spleen, resulting in enlargement.
What is a haemangioma?
A benign tumour made of extra blood vessels in the skin, which can cause diffuse splenic swelling.
What are infective causes of splenomegaly?
Bacterial infections (e.g., streptococcal, TB, brucellosis), fungal infections (e.g., histoplasmosis), viral infections (e.g., EBV, HIV), and protozoal infections (e.g., toxoplasmosis, malaria).
How do infective causes affect splenomegaly?
They stress splenic immune function, causing it to overproduce antibodies and immune cells (hyperplasia).
