Splenomegaly, Cause of Splenomegaly or Enlarged Spleen

SPLENOMEGALY or Enlarged Spleen
Enlargement of Spleen is called Splenomegaly.
Spleen is situated in the left hypochondrium below the stomach. When It is enlarged It can be palpated in the left anterolateral coastal margin.
There are various causes of splenomegaly (enlargement of the spleen).
Some of the causes of splenomegaly (enlarged Spleen) are given below.

Causes Of Enlarged Spleen ( Splenomegaly)

Congestion

• Cirrhosis
• Hepatic vein occlusion Portal or splenic vein thrombosis
• Congestive cardiac failure
• Constrictive pericarditis

Infections
Acute infections
Typhoid Fever, septicemia, Infective endocarditis, Infectious mononucleosis, hepatitis, CMV
Chronic infections
Tuberculosis, brucellosis
Parasitic infestation
Malaria, kalazar, schistosomiasis, trypanosomiasis
Fungal infection
Histoplasmosis

Inflammation

• SLE,
• sarcoidosis,
• Felty’s syndrome

Haematological disorders

• Hemolytic anaemias
• Hemoglobinopathies such as thalassemia, Autoimmune hemolytic anemia, Megaloblastic anemia

Myeloproliferative disorders

• Chronic myeloid leukaemia
• Myelofibrosis
• Polycythemia Vera
• Essential thrombocytopenia

Neoplastic

• Leukaemia,
• lymphoma,
• metastatic cancer

Storage disease

• Gaucher’s disease,
• Niemann - Pick disease

Miscellaneous

• Hyperthyroidism,
• amyloidosis,
• cysts.

Massive splenomegaly More than 8 cm below the to the umbilicus.

• Malaria
• Kalazar
• Chronic myeloid leukaemia
• Primary lymphoma of the spleen
• Portal hypertension

Moderate Splenomegaly

About 4-8 cm below the left costal margin or large but not reaching to the umbilicus (usually 2-4 fingers).

• All causes of massive splenomegaly
• Portal hypertension (cirrhosis, CCF)
• Leukaemia (acute or chronic)
• Lymphoma
• Thalassemia
• Gaucher’s disease

Small Splenomegaly

Just palpable or 2-4 cm below the costal margin (1-2 fingers).

• Causes of massive and moderate splenomegaly
• Hematological: polycythemia, anemia, megaloblastic anemia.
• Infections: malaria, infective endocarditis, hepatitis, infectous mononucleosis.
• Connective tissue disease: SLE, polyarteritis nodosa.