What are the characteristics of splenomegaly on abdominal examination?
What are the characteristics of splenomegaly on abdominal examination?
The most common complaint in patients with splenomegaly is mild, vague, abdominal discomfort. Patients may also experience pain,which may be referred to the left shoulder. Increased abdominal girth is less common. Early satiety from gastric displacement occurs with massive splenomegaly.
How would you describe splenomegaly on a physical exam?
When the patient inspires, the spleen moves inferiorly along the posterolateral abdominal wall. If the spleen is enlarged enough that the inferior pole reaches the eighth or ninth intercostal space, a dull percussion note will be appreciated, indicating splenomegaly.
How do you examine splenomegaly?
Palpation for splenic enlargement should begin with the patient supine and with knees flexed. Using the right hand, the examiner should begin well below the left costal margin and feel gently but firmly for the splenic edge by pushing down, then cephalad, then releasing (Figure 150.1).
How does splenomegaly look like?
An enlarged spleen typically causes no signs or symptoms, but sometimes it causes: Pain or fullness in the left upper belly that can spread to the left shoulder. A feeling of fullness without eating or after eating a small amount because the spleen is pressing on your stomach. Low red blood cells (anemia)
How would you describe splenomegaly?
Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen.
Can an enlarged spleen be palpated?
A normal-sized spleen almost always lies entirely within the rib cage and thus cannot be palpated, but with enlargement it displaces the stomach and descends below the rib cage [4].
What is borderline splenomegaly?
Overview. Splenomegaly is a condition that occurs when your spleen becomes enlarged. It’s also commonly referred to as enlarged spleen or spleen enlargement. The spleen is a part of your lymphatic system. It helps the immune system by storing white blood cells and helping in the creation of antibodies.
Is a 15 cm spleen normal?
Splenomegaly refers to enlargement of the spleen. The upper limit of normal adult splenic length is traditionally cited at 12 cm, but lengths upwards of 14 cm can be seen in normal, taller males 7.
How is the physical examination of splenomegaly done?
The physical examination should include palpation with the patient in the supine and right lateral decubitus position, with knees up and hips flexed. Apply light fingertip pressure as the patient slowly inspires. The use of the reverse Trendelenburg position may aid in bringing the spleen into contact with…
How big is a massive splenomegaly in centimeters?
Massive splenomegaly is variably defined, including when the spleen is 5 standard deviations above the mean normal volume (about 943 cm 3) 4, heavier than 1000 g 5 or 1500 g 8, longer than 18 cm 8, or extending into the pelvis or across midline 4.
What is the purpose of the spleen exam?
Introduction to the Spleen Exam. The purpose of both palpation and percussion of the spleen is to look for splenic enlargement. Evaluation of splenomegaly is notoriously difficult and embarrassingly easy to miss when present. In part this is because the spleen enlarges in the inferior anteromedial direction, sometimes as far as the RLQ.
Where does the splenic Pole go in splenomegaly?
In extreme splenomegaly, shown in the image below, the lower splenic pole may extend into the pelvis or cross the abdominal midline. In these circumstances, palpation at the pelvic brim or the right upper quadrant may be necessary to delineate splenic size and location.
