Splenomegaly

 

Splenomegaly

Definition

It is a condition characterized by an enlargement of the spleen,so that it becomes palpable clinically.

Aetiology

 

Mechanism	Conditions
Acute infections	.Typhoid. .Subacute bacterial endocarditis. .Miliary tuberculosis. .Malaria. .Typhus.
Chronic infections	.Malaria. .Syphilis. .Tuberculosis.
Diseases of blood	.Chronic myeloid leukemia. .Congenital haemolytic anaemia. .Thrombocytopenic purpura.
Portal hypertension	.Cirrhosis of liver. .Prehepatic portal hypertension. .Hepatic venous thrombosis.
Splenic masses	.Hydatid cyst. .Abscess. .Aneurysm.

 

Treatment

1.Treatment of the cause.

2.Splenectomy.

Splenectomy

Indications

1.Rupture of spleen.

2.Hypersplenism:Excessive enlargement of spleen,associated with hyperfunction of spleen causing anaemia.

3.Failure of medica treatment to reduce the size of the spleen.

4.Haemolytic jaundice

 

Preoperative care

1.Platelet count is confirmed to be adequate.

2.Preparation is done as for any major abdominal surgery.

3.Nasogastric tube is passed.

 

Postoperative care

 

1.Care is taken to prevent thrombosis.

2.Early ambulation is promoted.

3.Painkillers are given to relieve pain.

4.Nasogastric tube is kept in place for at least 24 hours. Nasogastric suction is done continuously and 2 hourly.

5.Adequate hydration is maintained so as to maintain fluidity of blood.

6.Proper position is given in bed. This position is changed periodically.

7.Patient is made to perform breathing exercises.

8.Patient is made to perform leg exercises.

9.Heparin is given as adviced by  the doctor.

10.Other treatment is as after a major abdominal operation.