HypersplenismHypersplenism is an overactive spleen. The spleen is an organ found in the upper left side of your belly area. The spleen helps filter old and damaged cells from your bloodstream. If your spleen is overactive, it removes the blood cells too early and too quickly.The spleen plays a key role in helping your body fight infections. Problems with the spleen can make you more likely to develop infections.CausesHypersplenism can be caused by: Cirrhosis Lymphoma Malaria Tuberculosis Various connective tissue and inflammatory diseasesSymptomsSymptoms include: Enlarged spleen Low levelof one or moretypes of bloodcells Feeling full too soon after eating Stomach pain on the left side

TreatmentSuccessfulmedical treatmentof the primary disorder in cases of splenomegaly can lead to regression of the hypersplenism without the need for surgery.Splenectomy is indicated to help control or stage the basic disease in cases of splenomegaly. Splenectomy is also indicated for thetreatmentof chronic, severe hypersplenismIn rare cases, splenectomy may be used to treat thromboticthrombocytopenic purpura(TTP); however, therapeutic plasma exchange transfusion (plasmapheresis) has largely supplanted the need for splenectomy.

Inpatient careInpatientcare for patients with splenomegaly depends on the modality used to treat the underlying cause of the condition. These therapies are not unique to splenomegaly treatment .Outpatient careOutpatient care of patients with splenomegaly consists of 3 main focus areas: (1) primary etiologic disease (2) blood count monitoring, especially when associated with a myeloproliferative disease as the cause (3) monitoring for overwhelming postsplenectomy infection (OPSI).Thrombocytosis may require treatment when theplatelet countexceeds 1 million/L.. Whether any discrete benefit is gained by also controlling the platelet count remains unclear.

TransferTransfer of patients with splenomegaly is not generally required except for complications of surgery or OPSI. Patients undergoing elective splenectomy for splenomegaly may develop significant hemorrhaging during their operation if difficulty occurs controlling the splenic hilum. Such patients may require abdominal packing and transfer to a tertiary center .Such centers usually have the additional resources (eg, a well-stockedblood bank, a tertiary level intensive care unit) to support the organ systems in these patients.

Splenomegaly

Splenomegalyis an enlargement of thespleen. The spleen usually lies in the left upper quadrant (LUQ) of thehuman abdomen. It is one of the four cardinal signs ofhypersplenism, some reduction in the number of circulating blood cells affectinggranulocytes,erythrocytesorplateletsin any combination

DefinitionPoulinet al classify splenomegaly as: Moderate splenomegaly, if the largest dimension is between 1120cm Severe splenomegaly, if the largest dimension is greater than 20cm Splenomegaly refers strictly to spleen enlargement, and is distinct fromhypersplenism, which connotes overactive function by a spleen of any size. Splenomegaly andhypersplenismshould not be confused. Each may be found separately, or they may coexist.