hepatosplenomegaly

introduction

craniocaudal measurement of 11-13 cm is frequently used as the upper limit of normal splenic size on imaging studies
2-5% of the population have a palpable spleen
patients with hepatomegaly or splenomegaly should be advised to avoid all contact sports as there is a risk of fatal organ rupture
splenic rupture risk is higher in older patients as the splenic capsule thins with age

inflammatory response to infection or auto-immune conditions:
hypertrophy due to increased work of RBC destruction:
- thallasaemia major
- malaria
- hemoglobin SC disease
- NB. sickle cell disease results in a small, infarcted spleen rather than splenomegaly
venous congestion:
- congestive cardiac failure
- portal hypertension eg. cirrhosis
myeloproliferative:
- eg. chronic myeloid metaplasia
infiltrative / metabolic:
- sarcoidosis
- amyloidosis
- Gaucher's disease
- Niemann Pick disease
- Hurler's syndrome
- some neoplasia / cancer / tumours
neoplastic:
- chronic lymphocytic leukemia
- lymphoma
- metastases
miscellaneous:
- traumatic haematoma
- cysts
- abscesses