Splenomegaly is the enlargement of the spleen beyond its normal size (typically >12 cm), often caused by underlying infections (mononucleosis), liver disease (cirrhosis), or blood cancers (lymphoma). Symptoms include left upper abdominal pain, fullness, or early satiety. Treatment focuses on the underlying cause, with prognosis often good, though it carries risks of infection and rupture.
Cleveland Clinic +4
Causes of Splenomegaly
The spleen enlarges due to increased functional demand (e.g., clearing abnormal cells), infection, inflammation, or obstruction of blood flow. Common causes include:
Cleveland Clinic +1
- Infections: Infectious mononucleosis (EBV), malaria, subacute bacterial endocarditis.
- Liver Disease: Cirrhosis, portal hypertension.
- Hematologic Malignancies: Lymphoma, leukemia, myelofibrosis.
- Inflammatory/Autoimmune: Rheumatoid arthritis, lupus (SLE).
Storage Disorders: Gaucher disease.
Cleveland Clinic +4
Symptoms of Splenomegaly
Many individuals are asymptomatic, with the condition found during a routine physical exam. When symptoms occur, they include:
WebMD
- Pain or discomfort in the upper left abdomen, which may radiate to the left shoulder.
- Feeling full quickly or having a low appetite.
Signs of the underlying condition, such as fever, fatigue, or jaundice.
National Institutes of Health (NIH) | (.gov) +1
Complications
- Rupture: An enlarged spleen is softer and more vulnerable to rupture, which can cause life-threatening internal bleeding.
Hypersplenism: The enlarged organ may trap and destroy too many blood cells, leading to anemia, increased infection risk (low white cells), and bleeding issues (low platelets).
Mayo Clinic +3
Treatment and Prognosis
- Treatment: Focuses on treating the underlying cause, such as antibiotics for infection or specialized therapies for cancer. In some cases, a splenectomy (surgical removal) may be required.
- Prognosis: Often, treating the underlying condition allows the spleen to return to normal size. Without treatment, it may lead to severe complications.
Precautions: Patients should avoid contact sports to prevent rupture.
Cleveland Clinic +3
Diagnosis
- Physical Exam: A doctor can often feel an enlarged spleen during a physical exam.
- Imaging/Blood Tests: Ultrasound, CT scans, and blood tests (CBC) are used to measure size and determine the cause