Splenomegaly
| Classification according to ICD-10 | |
|---|---|
| R16.1 | Splenomegaly, not elsewhere classified |
| ICD-10 online (WHO version 2019) | |
In medicine, splenomegaly is the enlargement of the spleen beyond its normal size. It is an examination finding that can be found in various diseases. In question are hematological diseases such as leukemia and lymphoma , infections with bacteria or viruses (such as the Epstein-Barr virus ), rheumatic diseases, storage diseases and diseases that a backflow of blood into the splenic vein causing (especially cirrhosis ). The diagnosis of splenomegaly is usually made through an ultrasound scan . Splenomegaly can lead to what is known as hypersplenism : the healthy spleen filters the blood and sorts out old red blood cells ; if it is enlarged, it can store blood cells and cause a general shortage of blood cells ( pancytopenia ). Therapy for splenomegaly and hypersplenism is done by treating the underlying disease. In rare cases, the enlarged spleen must be surgically removed ( splenectomy ). Splenomegalia also occur in animals.
Underlying diseases
Splenomegaly can be a symptom of various diseases. In addition to hematomas as a result of trauma , these can include hematological and lymphatic underlying diseases such as leukosis , polycythemia vera , essential thrombocythemia , lymphomas , Castleman's disease or leukemia . Acute and chronic infections , for example with the Epstein-Barr virus or malaria , can also cause splenomegaly. Acute and chronic backflow of blood from the portal vein, such as portal hypertension , splenic vein thrombosis or right heart failure, can also be the cause. Moreover, even rheumatological underlying diseases, storage diseases such as Gaucher disease , Niemann-Pick disease type C, sarcoidosis or amyloidosis , Milzabszesse , hemangiomas , Littoralzellangiome , cysts , echinococcosis , sarcomas , erythropoietic Protoporphyrien , mononucleosis , a brucellosis , a spherocytosis , immune deficiencies as in variable immunodeficiency syndrome or metastases from tumors cause splenomegaly.
Diagnosis
The diagnosis is usually made by ultrasound , magnetic resonance imaging, and / or computed tomography . In addition to measuring the size of the spleen, these examination techniques also allow a pictorial representation of the internal structure of the spleen and can provide information about the underlying disease. The physical examination may show local tenderness below the left costal arch and an enlarged palpable spleen. Splenomegaly can lead to overstretching of the spleen tissue and thus to spontaneous rupture of the spleen . Clinically, depending on the extent of the bleeding, hemorrhagic shock and pain in the left upper abdomen are evident . The diagnosis here is also made by ultrasound or computed tomography.
therapy
The therapy of a splenomegaly initially includes the therapy of the respective underlying disease. If a rupture occurs, a splenectomy is indicated.
literature
- Herbert Renz-Polster, Steffen Krautzig (Hrsg.): Basic textbook internal medicine. 5th edition. Urban & Fischer, Munich 2013, ISBN 978-3-437-41114-4 , p. 280 f.
- Gerd Herold and colleagues: Internal Medicine 2013. Self-published, Cologne 2013, ISBN 978-3-9814660-2-7 , p. 127 f.
- Keyword "Splenomegaly" in: Pschyrembel Medical Dictionary. 266th edition, de Gruyter, Berlin 2014, ISBN 978-3-11-033997-0 , p. 1997 f.
Individual evidence
- ↑ Michael J. Day: Atlas of clinical immunology in dogs and cats. Schlütersche, 2005, p. 262.
- ^ Basic course in hematology. Georg Thieme Verlag, 2003, p. 306.
- ^ A b Günter Schmidt: Ultrasound course book: according to the guidelines of DEGUM and KBV. Georg Thieme Verlag, 2008, p. 110 ff.
- ↑ Paul Gerhardt Scheurlen: Differential diagnosis in internal medicine. Springer-Verlag, 2013, p. 85.
- ^ A b Carlos Thomas: Special Pathology. Schattauer Verlag, 1996, p. 501.
