How is splenomegaly to return a responsibility?

summary

"Splenomegaly" is an important pathological sign, because the disease often has complications. Under normal circumstances, the spleen can not be touched, but in people with low diaphragm or thin constitution, especially women, occasionally can touch the edge of the spleen, but the texture of the spleen is soft and there is no tenderness, which is quite different from pathological splenomegaly. Now let's learn about splenomegaly? It's a matter of time.

How is splenomegaly to return a responsibility?

First, patients with splenomegaly usually have discomfort or even fullness in their left upper abdomen, and also show symptoms of red blood cell, leucopenia and thrombocytopenia, such as anemia, easy infection and difficulty in hemostasis after bleeding. This is the result of splenomegaly and hypersplenism. Patients also show systemic symptoms such as fever, sweating, weight loss and enlarged lymph nodes, Of course, this will vary according to the specific disease. It is very important for clinicians to make etiological diagnosis of splenomegaly to explain the history and personal feelings in detail.

Second: abdominal physical examination: under normal circumstances, the spleen can not be touched. If you can touch the edge of the spleen in supine position or right lateral position with professional examination techniques, it should be considered as splenomegaly. However, there will be some false positives. About 16% of the patients' abdominal physical examination touch the spleen, but the subsequent imaging examination shows that the size of the spleen is normal, just like the people with thin constitution mentioned at the beginning. Therefore, if the abdominal physical examination touch the spleen, further imaging examination should be carried out to exclude false positives.

Third: ultrasound examination: abdominal B-ultrasound is the most commonly used examination, which is relatively safe, fast and easy to accept for most patients. In addition, the specificity and sensitivity of ultrasound examination are also relatively high. It is generally believed that splenomegaly can be diagnosed when the length of spleen is more than 13cm. Due to the influence of individual differences, examination instruments and other factors, The normal values measured by various medical units will be different. No one can guarantee that the examination is 100%. Ultrasound examination is also easy to cause false positive for people whose spleen is located in the front.

matters needing attention

Therefore, many causes can cause splenomegaly. How to treat splenomegaly? It is self-evident that we should give targeted treatment according to the etiology of splenomegaly. So when we meet patients with splenomegaly in clinic, what we should do first is to actively find the primary disease, and then determine the next treatment plan. Splenectomy is mainly used for splenic rupture, splenic tumor, portal hypertension with hypersplenism and other diseases caused by congestive splenomegaly. Based on the further understanding of spleen function at present, more and more scholars advocate that the principle of spleen preservation surgery should be carried out as far as possible when conditions and diseases permit, that is, the principle of "saving life first, preserving spleen second, the younger the priority of spleen preservation".