Let’s take a look at splenic pathology.
With splenomegaly, remember
Remember the portal vein
is being formed by the
splenic vein and the
superior mesenteric vein.
So therefore anytime that
you would expect there
to be what’s known as
you’d expect there
to be splenomegaly,
portal vein thrombosis
or heart failure.
What kind of heart failure
may result in splenomegaly?
Take your time, use common sense.
Back up into liver and then eventually
back up into spleen, splenomegaly.
What else may cause splenomegaly?
Lymphoproliferative diseases are important
and now at this point,
it would be in your best interest
to know the anatomy of your spleen.
And this is a weak area
for a lot of medical students along
with the lymph node as well.
But at least know that there
might be marginal zone lymphoma,
an actual cancer that might be
taking place in your spleen
resulting in left upper
Storage diseases may result in splenic
distention or perhaps even amyloidosis.
Amyloidosis really does not
spare any organ per se.
Any organ is pretty much at risk
of being damaged with amyloidosis.
terms of infection.
You’ve heard of kissing disease.
In developed countries in which you have
a child that has gone on to college
and maybe partying at a fraternity
and so forth, maybe passing beers,
meaning to say that they
might be passing EBV.
Epstein-Barr virus is then going to affect
your child resulting in mononucleosis.
And with that type of infectious
mononucleosis, at some point in time,
by far, what you’re worried
about here is splenomegaly.
And at some point in
time, if there’s trauma,
that is experienced by this
young male, young female,
there might be splenic rupture and resulting
in massive intraperitoneal hemorrhage,
bleeding and perhaps even,
well, hypovolemic shock.
does it mean to you?
Whenever there is spleen
that is undergoing
increased functioning or
it is being enlarged,
there could be congestion of
blood in the spleen causing
sequestration of blood elements
resulting in, well, anemia.
At times, there might
be increased activation
of your spleen depending as
to what the needs will be.
Both processes leads to –
well, if there’s sequestration
of blood components,
maybe it’s sequestering
welcome to anemia.
Maybe it’s sequestering platelets,
welcome to thrombocytopenia.
And your patient is going
to present with bleeding.
In some cases, there is a risk of traumatic
splenic rupture, which we talked about.
And that hemoperitoneum or
the massive loss of blood
may result in hypovolemic shock or
perhaps even potentially fatal.