Splenomegaly – wikipedia electricity nyc

Splenomegaly refers strictly to spleen enlargement, and is distinct from hypersplenism, which connotes overactive function by a spleen of any size. Splenomegaly and hypersplenism should not be confused. Each may be found separately, or they may coexist. Clinically, if a spleen is palpable (felt via external examination), it means it is enlarged as it has to undergo at least twofold enlargement to become palpable. However, the tip of the spleen may be palpable in a newborn baby up to three months of age. Age

For children, the cutoffs for splenomegaly are given in this table [missing], when measuring the greatest length of the spleen between its dome and its tip, in the coronal plane through its hilum while breathing quietly. [5] Signs and symptoms [ edit ]

Signs of splenomegaly may include a palpable left upper quadrant abdominal mass or splenic rub. It can be detected on physical examination by using Castell’s sign, Traube’s space percussion or Nixon’s sign, but an ultrasound can be used to confirm diagnosis. In patients where the likelihood of splenomegaly is high, the physical exam is not sufficiently sensitive to detect it; abdominal imaging is indicated in such patients. [6] Causes [ edit ]

The most common causes of splenomegaly in developed countries are infectious mononucleosis, splenic infiltration with cancer cells from a hematological malignancy and portal hypertension (most commonly secondary to liver disease, and sarcoidosis). Splenomegaly may also come from bacterial infections, such as syphilis or an infection of the heart’s inner lining ( endocarditis). [7]

If the splenomegaly underlies hypersplenism, a splenectomy is indicated and will correct the hypersplenism. However, the underlying cause of the hypersplenism will most likely remain; consequently, a thorough diagnostic workup is still indicated, as, leukemia, lymphoma and other serious disorders can cause hypersplenism and splenomegaly. After splenectomy, however, patients have an increased risk for infectious diseases.

Patients undergoing splenectomy should be vaccinated against Haemophilus influenzae, Streptococcus pneumoniae, and Meningococcus. They should also receive annual influenza vaccinations. Long-term prophylactic antibiotics may be given in certain cases.

In cases of infectious mononucleosis splenomegaly is a common symptom and health care providers may consider using abdominal ultrasonography to get insight into a person’s condition. [14] However, because spleen size varies greatly, ultrasonography is not a valid technique for assessing spleen enlargement and should not be used in typical circumstances or to make routine decisions about fitness for playing sports. [14] As an adaptation [ edit ]

• ^ Saboo, S S; Krajewski, K M; O’Regan, K N; Giardino, A; Brown, J R; Ramaiya, N; Jagannathan, J P (2012). "Spleen in haematological malignancies: spectrum of imaging findings". The British Journal of Radiology. 85 (1009): 81–92. doi: 10.1259/bjr/31542964. ISSN 0007-1285. |access-date= requires |url= ( help)

• ^ a b Rosenberg, H K; Markowitz, R I; Kolberg, H; Park, C; Hubbard, A; Bellah, R D (1991). "Normal splenic size in infants and children: sonographic measurements". American Journal of Roentgenology. 157 (1): 119–121. doi: 10.2214/ajr.157.1.2048509. ISSN 0361-803X.

• ^ Sproat, LO.; Pantanowitz, L.; Lu, CM.; Dezube, BJ. (Dec 2003). "Human immunodeficiency virus-associated hemophagocytosis with iron-deficiency anemia and massive splenomegaly". Clin Infect Dis. 37 (11): e170–3. doi: 10.1086/379613. PMID 14614691.

• ^ Suvajdzić, N.; Cemerikić-Martinović, V.; Saranović, D.; Petrović, M.; Popović, M.; Artiko, V.; Cupić, M.; Elezović, I. (Oct 2006). "Littoral-cell angioma as a rare cause of splenomegaly". Clin Lab Haematol. 28 (5): 317–20. doi: 10.1111/j.1365-2257.2006.00801.x. PMID 16999722.

• ^ a b American Medical Society for Sports Medicine (24 April 2014), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Medical Society for Sports Medicine , retrieved 29 July 2014 , which cites

• Putukian, M; O’Connor, FG; Stricker, P; McGrew, C; Hosey, RG; Gordon, SM; Kinderknecht, J; Kriss, V; Landry, G (Jul 2008). "Mononucleosis and athletic participation: an evidence-based subject review". Clinical Journal of Sport Medicine. 18 (4): 309–15. doi: 10.1097/jsm.0b013e31817e34f8. PMID 18614881.