The liver and spleen are closely interconnected by the collar vein system and have common paths of lymph flow and innervation. If a problem occurs in one organ, it inevitably affects the other. Hepatosplenomegaly is an enlargement of the liver and spleen that occurs at the same time.
Diagnosis
Diagnosis of this syndrome is based on the patient's complaints. Age matters, time when pain or discomfort arose, causes, hereditary factors.
Then the doctor performs a percussion and palpation examination. Hepatosplenomegaly may be detected by visual examination. It looks like a swelling under the right hypochondrium, which moves when you inhale.
To clarify the diagnosis, laboratory diagnostics is necessary, which reveals the functional state of the liver. For this, various tests are carried out, such as checking the level of ceruloplasmin, serum iron and other indicators.
An echoscope is used as an instrumental examination, and thencomputed tomography is scheduled. But only angiography can reveal the most accurate dimensions of the liver, it also allows you to determine the nature of the lesion and identify possible obstructions to blood flow.
Reasons
Hepatosplenomegaly is a syndrome that develops in a number of diseases. Enlargement of the liver and spleen does not cause concern in itself, although this is what worries the patient the most. No matter how dangerous hepatosplenomegaly may seem, the causes must be clarified first. The efficiency and effectiveness of treatment depends on this. All reasons can be conditionally divided into five groups:
- Acute liver diseases, in which blood circulation in the portal vein system is disturbed. These include hepatitis, cirrhosis, vascular lesions.
- Chronic infections and parasitic infestations. These are malaria, infectious mononucleosis, syphilis, leishmaniasis, brucellosis and others.
- The third group includes metabolic diseases - hemochromatosis, amyloidosis.
- The fourth group includes systemic blood diseases - anemia, leukemia, Hodgkin's disease.
- The fifth group includes diseases of the cardiovascular system with the development of chronic heart failure: hypertension, congenital and acquired heart defects, coronary heart disease.
Hepatosplenomegaly in children
Hepatosplenomegaly in a child can be observed at any age, including a newborn. The increase, as in adults, is determined by palpation. Hypatosplenomegaly in young children is usually accompanied by jaundice, anemia, and fever. For a correct diagnosis, it is first necessary to determine the nature of jaundice (hemolytic or parenchymal). This will allow you to develop the right treatment tactics.
In the first hours of life, hepatosplenomegaly in combination with jaundice is quite often the result of intrauterine infection with tuberculosis or syphilis. Often, hepatosplenomegaly becomes a consequence of congenital hepatitis or cirrhosis. At the same time, the surface of the liver is uneven, the consistency is firm. A strong increase in very young children is observed with anomalies of the biliary tract. In this case, jaundice grows rather quickly, accompanied by chalky, umbilical bleeding. Signs of biliary cirrhosis with portal hypertension appear rapidly.
In older children, the simultaneous enlargement of the liver and spleen may not be associated with a viral or bacterial infection, but with an elementary violation of proper nutrition. Fatty food, rich in carcinogens, is a serious burden on the internal organs. The first blow is taken by the liver, which acts as a filter in the body. As a result, unable to cope with a large number of harmful components, the liver increases in size and entails changes in the spleen.
Treatment
After a thorough examination and clarification of the causes, the underlying disease is treated. Hepatosplenomegaly is not a disease, but a syndrome. Special or universal treatment is not required. As maintenance therapy for the liver, cholespasmolytics are prescribed (drugs "Papaverine", "No-shpa", "Platifillin"), choleretic drugs ("Holosas", "Xylit"), hepatoprotectors (drugs "Silibor", "Essentiale", "Geptral ", "Karsil", "Riboxin" and others). In parallel, hormonal therapy is being carried out, such as Prednisolone and multivitamin complexes.
When a phenomenon such as hepatosplenomegaly occurs, the treatment is accompanied by the obligatory normalization of the intestinal biocenosis. Doctors may prescribe drugs containing lacto and colibacilli, such as "Linex", "Primadophilus", "Bifiform", "Hilak-forte" and others.
Diet
Fatty foods, preservatives, dyes and carcinogens contained in many foods adversely affect the liver, stomach, and spleen. To help the internal organs defeat the disease, it is important to adhere to a strict diet, at least for the duration of treatment. The diet should consist of dietary, low-fat and fresh food. There should be no sausages, chips, yogurts for long-term storage. The basis of the diet is dietary soups, cereals without butter, fat-free cottage cheese. Tea, coffee and juices with long shelf life are replaced by plain mineral water, homemade compotes and jelly. Cakes, pastries and other fatty desserts are also contraindicated. Bettergenerally give up sweets or limit yourself to green tea with honey and crackers. Hepatosplenomegaly is a phenomenon that can be eliminated only with the joint efforts of the doctor and the patient.
