The Spleen Flashcards
What are the common causes of splenomegaly?
Infection
Inflammation
Portal hypertension
Haematological disease
What are the infective causes of splenomegaly?
Infective endocarditis Bacterial sepsis EBV TB Malaria Schistosomiasis
What are the inflammatory causes of splenomegaly?
RA
SLE
Sarcoidosis
What are the haematological causes of splenomegaly?
Haemolytic anaemia
Leukaemia
Lymphoma
Myeloproliferative disease
When is massive splenomegaly seen?
Myelofibrosis Chronic myeloid leukaemia Lymphoma Malaria Lieshmaniasis Gaucher's disease
What is massive splenomegaly?
Spleen palpable in RIF
What are the results of hypersplenism?
Pancytopenia
Increased plasma volume
Haemolysis
What are the indications for a splenectomy?
Splenic trauma
Hypersplenism
AI haemolysis (ITP, congenital haemolytic anaemias)
What are the potential causes of splenic rupture?
Blunt trauma mostly, can be penetrating
Pre-existing illness increases risk
How does splenic rupture present acutely?
Immediate massive bleeding
Peritonism (from progressive blood loss)
Shock
How can splenic rupture present sub-acutely?
Rupture occurs hrs/days after trauma
Expanding haematoma beneath capsule
What are the potential adverse complications of splenectomy?
Increased risk of infection (encapsulated organisms)
What additional management should be put in place post splenectomy?
Mobilise soon after op & give LMWH/aspirin Immunise according to local regimens Lifelong Pen V/erythromycin Carry alert cards Warn of malaria risk when travelling
