Hypersplenism
Introduction
Introduction Hypersplenism (referred to as splenic spleen) is a syndrome, clinical manifestations of splenomegaly, one or more blood cells, and bone marrow hematopoietic cells corresponding hyperplasia, can be relieved by splenectomy. After the treatment of the disease, some cases of clinical symptoms of hypersplenism (referred to as splenic spleen) is a syndrome, clinical manifestations of splenomegaly, one or more blood cells, and bone marrow hematopoietic cells corresponding hyperplasia Relieved by splenectomy. After the treatment of the disease, the clinical symptoms of some cases can be alleviated. After the spleen is removed, the clinical symptoms can be corrected. The shape can be alleviated. After the spleen is removed, the clinical symptoms can be corrected.
Cause
Cause
The spleen can be divided into primary and secondary. The cause is unknown, called primary spleen. Secondary splenomegaly can be seen in patients with more obvious splenomegaly, such as cirrhosis caused by various causes (especially schistosomiasis cirrhosis), chronic infections such as malaria, tuberculosis, malignant tumors such as lymphoma, chronic lymphoid Cellular leukemia, myelofibrosis, and chronic hemolytic anemia and rare reticuloendotheliosis.
Examine
an examination
Related inspection
Blood routine spleen imaging liver, gallbladder, spleen CT examination white blood cell count indirect bilirubin
(1) Spleen enlargement: In most cases, the spleen is swollen. For those who do not touch the spleen under the ribs, other tests should be performed to confirm whether the spleen is swollen. The spleen area scan after injection of 99m , 198 gold or 113m indium colloid helps to estimate the size and shape of the spleen. Computerized tomography can also measure spleen size and spleen lesions. However, the degree of splenomegaly is not necessarily proportional to the degree of hypersplenism.
(b) Hematocytopenia: Red blood cells, white blood cells or platelets can be reduced individually or simultaneously. In the early cases, only white blood cells are present, and in the advanced cases, complete blood cell reduction occurs.
(3) Bone marrow is a hematopoietic cell hyperplasia: some cases may also have maturity disorders at the same time, or a large number of peripheral blood cells may be destroyed, and mature cells are released too much, causing similar maturity disorders.
(D) changes in splenectomy: after splenectomy can make the number of blood cells close to or return to normal, unless the bone marrow hematopoietic function has been damaged.
(5) Radionuclide scanning: 51Cr-labeled platelets or red blood cells were injected into the body and scanned on the body surface. It was found that the amount of 51Cr in the spleen area was 2 to 3 times larger than that in the liver, suggesting that platelets or red blood cells were destroyed excessively in the spleen. When considering the diagnosis of spleen, the previous three are particularly important.
Diagnosis
Differential diagnosis
It mainly involves differential diagnosis of splenomegaly and differential diagnosis of cytopenia. The former is mainly the identification of various secondary spleen and spleen. In addition to the identification of various secondary splenomegaly, the latter needs to be differentiated from other various cytopenia, including aplastic anemia, non-leukemia leukemia, Myelodysplastic syndrome, paroxysmal nocturnal hemoglobinuria, multiple myeloma, megaloblastic anemia, chronic renal failure. Identification with chronic renal failure, detection of serum creatinine, urea nitrogen, can be clearly distinguished.
In the case of cirrhotic portal hypertension, the establishment and opening of the collateral circulation, splenomegaly and hypersplenism, ascites formation, may be referred to as the triad of portal hypertension. Among them, splenomegaly and hypersplenism (referred to as spleen sputum) is also a clinical syndrome, which is characterized by splenomegaly, and the peripheral blood cells are reduced by one or more lines, while the bone marrow hematopoietic cells are correspondingly hyperplasia, and the blood picture is restored after the spleen is removed.
The cause of spleen, also known as ectopic spleen or spleen sag, refers to the spleen leaving the normal anatomical location and located in other locations in the abdominal cavity or pelvic cavity. It often moves down the left side of the abdomen to the pelvic cavity. Most of the reasons are that the spleen pedicle and ligament are congenitally abnormal and loose; or because the splenomegaly is spleen spleen is elongated, or because the abdominal wall is slack, it cannot be fixed. Therefore, the spleen mostly occurs in middle-aged women with enlarged spleen.
