SPLEENOMEGALY

The Spleen is a ductless organ located in the upper left quadrant of the abdomen just below diaphragm protected under the lower left ribs. It filters the blood and maintains healthy red and white blood cells and platelets.
Because this sensitive organ is normally tucked away underneath the ribcage, it is protected from potential dangers that could cause it to tear, which would lead to serious internal hemorrhaging (bleeding).
Normally, the spleen is a small organ about the size of a small fist or orange. Splenomegaly describes the situation where the spleen enlarges in size.
Hypersplenism is the name given to the condition where the spleen becomes overactive and destroys more blood cells than it should. Symptoms depend on which blood component is lacking. For example, if red blood cells are deficient, anaemia will result (with symptoms including fatigue and pallor). Most cases of hypersplenism are caused by disorders somewhere else in the body, such as cirrhosis of the liver.

Cause-
An enlarged spleen can be caused by infections, cirrhosis and other liver diseases, blood diseases characterized by abnormal blood cells, problems with the lymph system, or other conditions.

Infections

o    Bacterial infections

o    Cat scratch disease

o    Infectious mononucleosis (EBV or CMV)

o    Other viral infections

o    Parasitic infections

·         Diseases involving the liver

o    Biliary atresia

o    Cirrhosis (alcoholic cirrhosis, portal vein obstruction, portal hypertension)

o    Cystic fibrosis

o    Sclerosing cholangitis

·         Hemolytic anemias

o    Hemoglobinopathies

o    Hemolytic anemia due to G6PD deficiency

o    Idiopathic autoimmune hemolytic anemia

o    Immune hemolytic anemia

o    Thalassemia

Cancer

§  Hodgkin's disease

§  Leukemia

§  Lymphoma

  Other causes:-

§  Felty syndrome

§  Sarcoidosis

§  Sickle cell splenic crisis

Symptoms-
An enlarged spleen often causes no symptoms. Some people, however, may experience one or more of the following symptoms of enlarged spleen:

o  Pain in the left upper abdomen that may spread to the left shoulder

o  Feeling full without eating or after eating only a small amount - this can occur when an enlarged spleen presses on your stomach

o  Anemia

o  Fatigue

o  Frequent infections

o  Easy bleeding

o  Diaphragm irritation may refer pain to the left shoulder

o  An enlarged spleen also can push toward the stomach and cause anorexia or a loss of appetite and a sense of early fullness when eating.

Diagnosis-
1.Computed blood cell count- looking for abnormal red blood cells and white blood cells.
2.Peripheral smear to assess at the types and shapes of blood cells or a monospot, if the diagnosis of infectious mononucleosis is being considered.
3.Radiological findings- X-ray, ultrasound, CT scan and MRI of abdomen to detect enlarged spleen.
Complication-
When your spleen is enlarged, the possibility of rupture is far greater. A ruptured spleen can cause life-threatening bleeding into your abdominal cavity.
Symptoms of rupture of spleen-

o    Pain on left side of upper abdomen

o    Pain radiating to left shoulder

o    Pain worsens when you breath

o    Troubles breathing

In some cases, a spleen may have a small tear resulting in a much slower loss of blood. However, this can lead to low blood pressure and an insufficient supply of oxygen to the brain and heart, which may become apparent through these symptoms:

o    Lightheadedness

o    Confusion

o    Blurred vision

o    Fainting

Treatment-
Treatment for an enlarged spleen is usually directed at the underlying medical condition that resulted in the splenomegaly.
These treatments are for the underlying disease and may allow the spleen to reduce in size; however, in some cases, the spleen will remain enlarged.
On occasion, the spleen may need to be removed surgically as part of the disease treatment.

Role of homoeopathy-
Homoeopathy shows good results in treating spleenomegaly. The medicine is selected on the basis of focusing on the whole organism giving importance to each and every alteration in the patient from healthy state to diseased state.

Please E-mail dr_ramanand@rediffmail.com for any questions/treatment