Overview (परिचय)
Splenomegaly एक clinical condition है जिसमें spleen (तिल्ली) का आकार सामान्य से अधिक हो जाता है। यह स्वयं कोई बीमारी नहीं है, बल्कि किसी underlying systemic disease का संकेत (clinical sign) होती है।
Splenomegaly अक्सर infection, liver disease, hematological disorders, malignancy और immune-mediated conditions में देखी जाती है।
Definition (परिभाषा)
Medical Definition (MBBS/MD)
Splenomegaly is defined as pathological enlargement of spleen beyond its normal anatomical limits, usually more than 13 cm in craniocaudal length on imaging.
Simple Explanation
सामान्य स्थिति में तिल्ली एक छोटा organ होता है। जब शरीर में infection, खून की बीमारी या liver problem होती है, तो तिल्ली ज़्यादा काम करने लगती है और धीरे-धीरे size में बढ़ जाती है।
Spleen Anatomy & Physiology (संक्षेप)
- Location: Left hypochondrium
- Normal length: 11–12 cm
- Weight: 150–200 g
- Functions:
- Old RBCs का destruction
- Immune surveillance
- Platelet sequestration
- Extramedullary hematopoiesis (pathological states)
Types of Splenomegaly
| Type | Description | Common Causes |
|---|---|---|
| Mild | Slight enlargement, often asymptomatic | Early infection |
| Moderate | Palpable below costal margin | Liver disease, anemia |
| Massive | Extends to pelvis / crosses midline | CML, Kala-azar, Myelofibrosis |
Symptoms of Splenomegaly – Simple Explanation + Medicines
1. Left Upper Abdominal Pain
Simple meaning: बाएँ ऊपरी पेट में दर्द क्योंकि तिल्ली बढ़कर आसपास दबाव डालती है।
Pathogenesis: Splenic capsule stretch + congestion
Medicines (Teaching Reference)
| Form | Medicine | Dose | Frequency | Duration |
|---|---|---|---|---|
| Tablet | Paracetamol | 500–650 mg | OD–BD (6–8 hr gap) | 3–5 days |
| Syrup | Paracetamol | 10–15 ml | BD–TDS | 3–5 days |
| Injection | Paracetamol IV | 1 g | 8 hourly | Hospital setting |
2. Fever (Intermittent / Low Grade)
Simple meaning: Infection के कारण बुखार आना।
Common causes: Malaria, Typhoid, TB
| Form | Medicine | Dose | Frequency | Duration |
|---|---|---|---|---|
| Tablet | Paracetamol | 500–650 mg | BD–TDS | Until fever subsides |
| Injection | Antibiotics | As per drug | As advised | Cause-based |
3. Weakness & Fatigue
Simple meaning: खून की कमी से कमजोरी।
Cause: Hypersplenism → RBC destruction
| Form | Medicine | Dose | Frequency | Duration |
|---|---|---|---|---|
| Tablet | Folic Acid | 5 mg | OD | 4–6 weeks |
| Tablet | Iron | 60 mg elemental | OD–BD | 2–3 months |
| Syrup | Hematinic | 10 ml | BD | 6–8 weeks |
🔗 Internal Read: Anemia – Causes & Treatment
4. Early Satiety (जल्दी पेट भर जाना)
Simple meaning: थोड़ा खाने पर पेट भर जाना।
Cause: Enlarged spleen compresses stomach
| Form | Medicine | Dose | Frequency | Duration |
|---|---|---|---|---|
| Tablet | Pantoprazole | 40 mg | OD (empty stomach) | 2–4 weeks |
| Syrup | Digestive enzymes | 10 ml | BD | 2 weeks |
5. Bleeding Tendency
Simple meaning: आसानी से खून बहना / नाक से खून।
Cause: Platelet sequestration in spleen
| Form | Management | Indication |
|---|---|---|
| Injection | Platelet transfusion | Platelets <20,000 or active bleeding |
Pathogenesis (Disease कैसे Develop होती है)
- Passive congestion (portal hypertension)
- Increased immune workload
- Abnormal cell infiltration
- Extramedullary hematopoiesis
Diagnosis & Pathology Tests
| Symptom | Tests |
|---|---|
| Fever | CBC, MP test, Blood culture |
| Weakness | Hb, Peripheral smear |
| Bleeding | Platelet count |
| Abdominal pain | Ultrasound abdomen |
Medicines Summary (Tablet | Syrup | Injection)
Tablet
- Paracetamol – Pain/Fever
- Folic Acid – Anemia
- Iron – Low Hb
- Pantoprazole – Gastric protection
Syrup
- Paracetamol syrup
- Hematinic syrup
- Digestive enzymes
Injection
- Paracetamol IV
- Antibiotics (cause-based)
- Platelet transfusion
Diet in Splenomegaly
Recommended Food
- Green leafy vegetables
- Seasonal fruits
- Protein rich diet
- Adequate fluids
🔗 Internal: Biotin Vitamin B7 के फायदे।
Avoiding Food
- Alcohol
- Junk food
- Excess oily food
- Raw unhygienic food
FAQs
क्या splenomegaly dangerous है?
Cause पर depend करता है। Early diagnosis से control संभव है।
कितने दिन तक medicine चलती है?
3 दिन से लेकर 3 महीने तक, cause के अनुसार।
क्या surgery जरूरी होती है?
Rare severe cases में splenectomy की जरूरत होती है।
Related Internal Articles
References
- WHO
- Mayo Clinic
- NHS
- StatPearls