Characteristics and causes of an enlarged spleen

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Characteristics and causes of an enlarged spleen
The mass appears from underneath the costal margin, enlarges towards the right iliac fossa, is firm, smooth, and may have a palpable notch. It is not possible to get above the spleen, it moves with respiration, is dull to percussion, and it cannot be felt bimanually.

Causes of an enlarged spleen:

  • Infection
    • bacterial infection (typhoid, typhus TB, septicaemia); 
    • viral infection (glandular fever); 
    • protozoal infection (malaria, kala-azar); 
    • spirochaete infection (syphilis, Leptospirosis—Weil's disease); 
  • cellular proliferation (myeloid and lymphatic leukaemia, myelosclerosis, spherocystosis, thrombocytopenic purpura, pernicious anaemia); 
  • congestion (portal hypertension - cirrhosis, portal vein thrombosis, hepatic vein obstruction, congestive heart failure); 
  • cellular infiltration (amyloid, Gaucher's disease); 
  • space occupying lesions (solitary cysts, hydatid cysts, lymphoma, polycystic disease).

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