What causes splenomegaly during physical examination

The physical examination found that splenomegaly may be caused by infectious diseases, blood system diseases, liver diseases, immune system diseases, genetic metabolic diseases and other reasons. Splenomegaly is usually manifested as discomfort, bloating, or compression symptoms in the upper left abdomen, and further clarification of the cause should be based on imaging examinations and laboratory indicators.

1. infectious diseases

Viral hepatitis, infectious mononucleosis, malaria and other infections may lead to splenic congestion and hyperplasia. EB virus infection is often accompanied by fever and sore throat symptoms, and atypical lymphocytes can be detected by blood smear examination. Acute phase requires bed rest, and antiviral drugs such as acyclovir tablets and ganciclovir capsules can be used according to medical advice. Chronic infections require regular monitoring of changes in spleen volume.

2. Hematological disorders

Leukemia, lymphoma, myelofibrosis, and other diseases can cause extramedullary hematopoiesis or tumor infiltration. The patient may have anemia, bleeding tendency, or lymph node enlargement, which can be diagnosed by bone marrow aspiration and flow cytometry. chemotherapy regimen should be selected based on the classification. For chronic myeloid leukemia, imatinib mesylate tablets can be used, while for primary myelofibrosis, fluconazole tablets can be considered.

3. Liver disease

Cirrhosis and portal hypertension are common causes of splenomegaly, which leads to passive congestion of the spleen due to obstructed blood flow. Patients often have signs such as liver palms and spider nevi, and gastroscopy shows esophageal and gastric varices. Protein intake should be restricted, and propranolol tablets should be used to reduce portal pressure. In severe cases of splenic hyperfunction, splenic artery embolization may be necessary.

4. Immune system diseases

Autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus can cause splenic immune hyperplasia. Laboratory tests show positive anti nuclear antibodies or elevated rheumatoid factor, and some patients may also have Felty syndrome. Treating underlying diseases is key, and immunosuppressive agents such as methotrexate tablets and hydroxychloroquine sulfate tablets can be used according to medical advice.

5. Genetic metabolic diseases

Lysosomal storage disorders such as Gaucher's disease and Nemanpil's disease can lead to lipid deposition in the spleen. Most of the children had growth retardation and bone pain, and foam cells could be seen in bone marrow examination. Enzyme replacement therapy, such as injection of Imosinase, can improve symptoms. When the spleen significantly enlarges and affects cardiovascular and pulmonary function, partial splenectomy should be considered. After discovering splenomegaly, vigorous exercise should be avoided to prevent splenic rupture, and blood routine and abdominal ultrasound should be regularly rechecked. Diet should choose easily digestible foods and limit the intake of rough and hard foods. If there is persistent fever, severe pain in the spleen area, or significant decrease in platelets, immediate medical evaluation should be sought to determine whether intervention treatment is needed. All medication treatments must be carried out under the guidance of a specialist doctor and cannot be adjusted on one's own.