Splenomegaly

　　1, Infectious

　　(1) Acute infection: seen in viral infection, rickettsial infection, bacterial infection, spiral infection, parasitic infection.

　　(2) Chronic infection: seen in chronic viral hepatitis, chronic schistosomiasis, chronic malaria, kala-azar, syphilis, etc.

　　2, Non-infectious

　　(1) Congestion: seen in liver cirrhosis, chronic congestive right heart failure, chronic constrictive pericarditis or large amounts of pericardial effusion, Budd-Chiari syndrome, idiopathic non-cirrhotic portal hypertension.

　　(2) Hematological diseases: seen in various types of acute and chronic leukemia, erythroleukemia, erythroblastosis, malignant lymphoma, malignant histiocytosis, idiopathic thrombocytopenic purpura, hemolytic anemia, polycythemia vera, myelofibrosis, multiple myeloma, systemic mastocytosis, hyperplastic splenomegaly, etc.

　　(3) Connective tissue disease: such as systemic lupus erythematosus, dermatomyositis, polyarteritis nodosa, juvenile rheumatoid arthritis (Still's disease), Felty's disease, etc.

　　(4) Histiocytosis: such as Letterer-Siwe disease, xanthoma disease syndrome, eosinophilic granuloma.

　　(5) Lipidosis: such as Gaucher's disease (Gaucher's disease), Niemann-Pick disease.

　　(6) Tumor and cyst of the spleen: Primary malignant tumors of the spleen are rare, and metastatic malignant tumors to the spleen are also rare. The primary cancer focus is often located in the digestive tract. Spleen cysts are rare and are divided into true and false cysts: true cysts include epidermal cysts, endothelial cysts (such as lymphangiomas) and parasitic cysts (such as echinococcosis), and false cysts include hemorrhagic, serous, or inflammatory ones.

　　It can cause hyperactivity of the spleen function. Hyperactivity of the spleen is a comprehensive symptom caused by diseases, which has a negative impact on the human spleen, leading to poor health. With the development of science and technology, the level of treatment is also constantly improving. It may present with symptoms such as hemolytic anemia, decreased granulocytes, and various complications depending on the primary disease.

　　1. Degree of splenic enlargement  The degree of splenic enlargement is related to the disease.

　　(1) Mild splenomegaly: when the lower margin of the spleen is 2 to 3 cm below the costal margin during deep inspiration, it is considered mild splenomegaly, and it can be seen in certain viral infections, bacterial infections, rickettsial infections, early schistosomiasis, congestive heart failure, liver cirrhosis portal hypertension, Hodgkin's disease, juvenile rheumatoid arthritis, systemic lupus erythematosus, tropical eosinophilia, idiopathic thrombocytopenic purpura, and other conditions.

　　(2) Moderate splenomegaly: when the lower margin of the spleen exceeds 3 cm below the costal margin to the level of the umbilicus, it is considered moderate enlargement, and it can be seen in acute myeloid leukemia, acute lymphocytic leukemia, chronic hemolytic anemia, infectious mononucleosis, vitamin D deficiency disease, splenic amyloidosis, malignant lymphoma, Niemann-Pick disease, and other conditions.

　　(3) Severe splenomegaly: when the lower margin of the spleen exceeds the umbilical level below, it is considered severe splenomegaly or macrocytic spleen, seen in chronic myelocytic leukemia, chronic malaria, advanced schistosomiasis, splenic leukemia, myelofibrosis, polycythemia vera, thalassemia, Gaucher's disease, and other conditions.

　　2. Texture of the spleen  The degree of splenic enlargement caused by different etiologies varies to different degrees. Generally, splenomegaly caused by acute infection is soft in texture; splenomegaly caused by chronic infection, leukemic cells, or tumor cell infiltration is hard in texture and uneven in surface; the texture of the spleen in liver cirrhosis is moderately hard; the texture of congestive splenomegaly varies with the degree and duration of congestion, with a soft texture when congestion is light and short-term, and a hard texture when congestion is severe or long-term, but generally with a full feeling. Cystic enlargement has a cystic feeling and an uneven surface. It must be pointed out that the degree and texture of splenic enlargement not only vary with the etiology but can also vary with the course of the disease, treatment conditions, and individual responsiveness. Attention should be paid to these factors when making a judgment.

　　3. Accompanying signs  In addition to splenomegaly caused by various etiologies, there are also different accompanying signs.

　　(1) Anemia, petechiae, or ecchymosis: seen in splenomegaly due to blood diseases, such as various types of leukemia, idiopathic thrombocytopenic purpura, and other conditions.

　　(2) Anemia and jaundice: seen in hemolytic anemia, chronic viral hepatitis, liver cirrhosis, malignant histiocytosis, sepsis, and other conditions.

　　(3) Liver and lymph node enlargement: seen in malignant lymphoma, lymphocytic leukemia, connective tissue disease, infectious mononucleosis, sarcoidosis, and certain infectious diseases, etc.

　　(4) Liver face, liver palm, and spider angioma: seen in chronic viral hepatitis and liver cirrhosis.

　　(5) Various types of rashes: commonly seen in various infectious diseases or infectious diseases, such as typhoid fever, spotted fever, brucellosis, sepsis, subacute bacterial endocarditis, and other conditions.

　　(6) Edema and ascites: seen in chronic right heart failure, constrictive pericarditis, liver cirrhosis portal hypertension, inferior vena cava obstruction, and other conditions.

　　(7) Cardiac enlargement: seen in chronic heart failure caused by various heart diseases, and large amounts of pericardial effusion caused by various reasons.

　　Patients with splenomegaly should develop good living habits in their daily lives: do not be picky about food, maintain balanced nutrition, keep hygiene, prevent infection, and pay attention to the prevention and treatment of complications. Once found, go to the hospital for examination and treatment immediately.

　　Laboratory tests are of great significance for the diagnosis of the cause of splenomegaly, including routine blood tests, platelet count, reticulocyte count, eosinophil count. Hemoglobin electrophoresis, erythrocyte fragility test, acid hemolysis (Ham), direct antiglobulin. Blood parasites, protozoa examination, liver function tests, bone marrow examination or biopsy. Serological antigen-antibody tests; lymph node puncture or biopsy, spleen puncture or biopsy, routine examination of ascites, etc.

　　Necessary instrumental examinations have important auxiliary diagnostic value for determining the cause of splenomegaly. Common examination methods include B-ultrasound, echocardiography, X-ray, CT, MRI, endoscopy, inferior vena cava angiography, etc.

　　For the diagnosis of splenomegaly, first determine whether there is splenomegaly, the degree of splenomegaly, and the texture. The second step is to understand the accompanying symptoms and signs of splenomegaly. By understanding the medical history, physical examination can make an initial diagnosis of the cause of splenomegaly, and then selectively perform relevant laboratory tests and necessary instrumental examinations, and finally make a diagnosis of the cause of splenomegaly.

　　Advantages:Eat more bitter-tasting foods, and also eat more sweet, refreshing fresh fruits and tender vegetables. Experts point out that kale, broccoli, watermelons, hawthorns, apples, grapes, and other foods are rich in minerals, especially calcium, magnesium, and silicon, which have the magical effect of calming the mind and reducing fire. Dietarily, eat more edible fungi such as black fungus, mushrooms, and shiitake mushrooms, which can enhance immunity. Fish are rich in protein and easy to digest.

　　Taboo:Do not eat cold, spicy, and刺激性 food, do not drink alcohol excessively, do not eat fried food, etc.

　　The main treatment method is to surgically remove the spleen. There are benefits to removing the spleen, as it can correct the harm caused by splenomegaly to the human body, but this method also has its shortcomings. After a total splenectomy, the patient's immune function will change, the spleen filtration function will disappear, IgM will decrease, cytokines and调理素 levels will decrease, the T lymphocyte system will be disordered, the number of peripheral blood lymphocytes and the lymphocyte turnover rate will decrease significantly, leading to a significant increase in the opportunity for fulminant infections, such as virulent pneumonia. For patients with poor liver function, ascites, hypoproteinemia, hematemesis, and other conditions, it should be considered comprehensively to decide whether splenectomy is necessary.