Hypersplenism
| Classification according to ICD-10 | |
|---|---|
| D73.1 | Hypersplenism |
| ICD-10 online (WHO version 2019) | |
The hypersplenism is a complication of splenomegaly . By enlarging the spleen , its functional capacity increases beyond what is necessary.
Pathophysiology
A spleen that is too large increases the elimination of erythrocytes (red blood cells), leukocytes (white blood cells) and thrombocytes (blood platelets) from the peripheral blood, in some cases considerably, resulting in pancytopenia (cell poverty). The individual cell lines are more or less severely affected. An anemia can regular blood transfusions require a thrombocytopenia increases the bleeding tendency, a leucopenia leads to an increased susceptibility to infections .
Reactive is to compensate for the cytopenia a hypertrophy of the blood-forming bone marrow instead. A strong enlargement of the spleen (splenomegaly) can cause additional pain or hinder neighboring organs through local compression.
therapy
The spleen is not a vital organ . Therefore, if there are serious and persistent complications such as hypersplenism, splenectomy (removal of the spleen) is indicated.
This eliminates the need for repeated regular blood transfusions in the case of anemia caused by hypersplenism, and any thrombocytopenia that may be present also usually improves.
Hyperplenism caused by portal hypertension is a special case . In this case, a splenectomy can be avoided in favor of the creation of a portosystemic shunt .
