1-Infective causes:
- Bacterial (Typhoid & paratyphoid, septicemia, pyogenic abscess, tuberculosis, typhus).
- Viral (infective hepatitis, infectious mononucleosis).
- Spirochaetal (Weirs disease, syphilis)
- Parasitic (Bilhariziasis, hydatid cyst, malaria,trypanosomiasis, kala azar).
2-Blood diseases:
- Leukaemias.
- Haemolytic anaemias (Spherocytosis, Cooley’s anaemia, acquired
- haemolytic anaemia, hypersplenism).
- Pernicious anaemia.
- Polycythaemia rubra vera.
- ldiopathic thrombocytopenic purpura.
3-Congestive splenomegaly:
- Due to portal hypertension.
4-Metabolic:
- Gaucher’s disease, amyloidosis, porphyria, rickets.
5-Tumors:
- Hemangioma, fibrosarcoma, lymphomas (commonest cause of neoplastic enlargement of spleen).
6-Non parasitic cysts
7-Collagen diseases:
- Felty’s syndrome and Still’s disease.
Huge splenomegaly
its enlarged spleen crossing the umbilicus.
Causes of huge splenomegaly:
- Bilharzias
- chronic myeloid leukemia
- chronic malaria- Kala Azar
- thalassemia major
- myelofibrosis
- amyloidosis
- Gaucher’s disease
Bilharzial splenomegaly:
Causes of splenomegaly in belharziasis
- Hyperplasia of RES due to absorption of Bilharzial toxins.
- Bilharziasis ) periportalfibrosis ) portal hypertension ) congestive Splenomegaly.
Treatment:
Splenectomy in patients with hepatosplenomegaly is indicated only in the following conditions:
1- Hypersplenism.
2- Huge splenomegaly.
3- Recurrent attacks of pain 2ry to splenic infarctions.
4- As a part of operations done for portal hypertension.