"Syndrome" in Greek means "aggregation" or "connection". In medicine, this characterization is given to diseases that have a certain number of recognizable features, often appearing together. Thus, the set of symptoms before an accurate diagnosis can be safely called a syndrome. One such condition is hepatolienal syndrome.
Characteristic
Hepato-splenic syndrome is the second name for this condition. It is characterized by an increase in the liver and spleen, respectively, the work of these organs is disrupted. Hepatolienal syndrome occurs in chronic diseases of the hepatobiliary system and disorders of blood circulation in the "portal vein - splenic vein" system.
Venous circulation in the liver and spleen provides an explanation of how these organs are connected and how they influence each other in such a deviation as hepatolienal syndrome. You can trace the venous connection of these organs.
The main vein is the portal vein. It collects blood fromspleen and other abdominal organs. Then it enters the liver, where it is cleared of harmful toxins and then distributes nutrients throughout the body. Part of the portal vein is the splenic, so the spleen is in very close connection with the liver and the processes occurring in it. This explains why the liver and spleen are affected in hepatolienal syndrome.
Pathogeny of hepatolienal syndrome
Impaired blood flow can occur due to narrowing of the lumen of the portal vein. There is stagnation of blood and, as a result, an increase in blood pressure. Why is this happening? Here are some reasons:
External compression of the portal vein. This can occur both inside the liver and on the hepatoduodenal ligament at the entrance to the organ. In this case, it is possible to observe the symptoms of hepatolienal syndrome with such diseases:
- Cirrhosis of the liver.
- Severe hepatitis.
- Thrombosis of the portal vein and adjacent large veins.
- Primary liver tumor.
- Cardiac pathologies of the right half of the heart.
- Bile duct diseases, tumors and cysts.
- Hepatic vein thrombosis.
2. Narrowing of the lumen of the veins:
- Thrombosis of the portal vein and its large branches.
- Hepatic vein thrombosis, or Budd-Chiari Syndrome.
In addition to damaging factors that can cause enlargement of the liver and spleen, this can also happen as a protective reaction of the body to microbes.
Stages
There are several stages of hepatolienal syndrome:
- The first stage can take several years. The general condition is satisfactory, moderate anemia, leukopenia and neutropenia are observed. The liver is not enlarged, but the spleen becomes much larger.
- The second stage is characterized by a significant increase in the liver. There are signs of violation of its functionality. May last several months.
- Third stage. Its duration is about one year. The decrease and thickening of the liver is characteristic, anemia increases, signs of hypertension, ascites, gastrointestinal bleeding, and esophageal varicose veins appear.
- The fourth stage. Characterized by general emaciation, swelling and symptoms of bleeding.
Causes of occurrence
Hepatolienal syndrome is most common in children.
Children and adults may have different causes:
- Hereditary diseases.
- Infectious diseases.
- Congenital hemolytic anemia.
- Congenital and acquired diseases of the portal vein, spleen.
- Hemolytic disease in the newborn.
- Chronic alcoholism.
Risk groups and their symptoms
All diseases that can provoke hepatolienal syndrome can be divided into groups:
- Acute and chronic liver disease. This group is characterized by pain or a feeling of heaviness in the right hypochondrium,dyspeptic disorders, pruritus, jaundice. Causes may include past viral hepatitis, contact with infectious patients, trauma or surgery, chronic alcoholism, taking hepatotoxic drugs, past acute abdominal pain, fever.
- Storage diseases. They are found among members of the same family or close relatives.
- Infectious and parasitic diseases. Accompanied by well-marked intoxication, fever, arthralgia and myalgia.
- Diseases of the cardiovascular system. They are accompanied by tachycardia, ischemic heart disease, accumulation of fluid in the pericardial cavity, enlargement and changes in the configuration of the heart.
- Diseases of the blood and lymphoid tissue. This group is characterized by symptoms such as weakness, fever, swollen lymph nodes.
Symptomatics
If the patient has hepatolienal syndrome, the symptoms may be as follows:
- Enlargement of the liver and spleen. Pain on palpation.
- Weight loss.
- The work of the endocrine glands is disrupted.
- Problems in the digestive tract.
- Anemia. Paleness and dryness of the skin.
- Possible accumulation of fluid in the abdomen.
- Muscle and joint pain.
- Yellowing of the whites of the eyes.
- Tachycardia, shortness of breath.
- Brittlenessnails, hair loss.
To make a diagnosis, it is necessary to undergo an examination, and for a more detailed analysis of organs - a diagnosis.
Diagnosis
If the above symptoms occur, differential diagnosis of hepatomegaly and hepatolienal syndrome is carried out. To do this, it is necessary to apply a whole range of measures. One of the first points is a general blood test and its biochemical study. To establish the cause of the hepatolienal syndrome, differential diagnosis is simply necessary. Within its framework:
- Echography of the liver and spleen, gallbladder, abdominal vessels.
- Computed tomography.
- Liver and spleen scan.
- X-ray examination of the duodenum.
- Laparoscopy.
- Puncture biopsy of the liver and spleen.
- Examination of the bone marrow and lymph nodes.
Currently, science does not stand still and the analysis of organs is constantly expanding in the diagnosis of a condition such as hepatolienal syndrome. Differential diagnosis of the underlying disease, taking into account the clinical picture and the state of the liver, if any, is the main task.
Treatment and complications of the disease
As a rule, therapy for hepatolienal syndrome consists in identifying the underlying pathological process and treating it. It is not an independent disease. If you have been diagnosed"hepatolienal syndrome", treatment should be carried out by a gastroenterologist. In this case, hepatoprotectors, antiviral drugs, hormones and vitamins are used. In each case, there should be an individual approach, taking into account the etiology of the disease.
If you miss the disease and do not treat, the prognosis can be deplorable. Complications of this syndrome are cirrhosis of the liver, thrombosis of the veins of the liver, inflammation of the gallbladder, blood diseases. In such cases, the removal of segments of the liver and spleen, or organ transplantation and blood transfusion.
At the first stage, patients are able to work and can withstand slight physical exertion. In the future, if the situation worsens, the patient becomes disabled.
Prevention
In order not to miss the beginning of the development of pathology, you must:
- Get regular blood and urine tests.
- Get screened on time, especially if you are at risk.
- Prevention of hepatolienal syndrome primarily involves the fight against the causes of diseases of the liver and spleen.
- It is imperative to follow a proper diet so that the food contains the necessary amount of fats, proteins and carbohydrates and, of course, vitamins.
- Do not abuse alcohol, smoke and lead a he althy lifestyle.
There are no harmless diseases, especially if they concern such vital organs as the liver and spleen. Timely detection of problems, and then adequatetreatments are capable of producing effective results.
