Enlarged Spleen and elevated liver enzymes

Good Morning,
I may have posted this question in the wrong place. I am seeing the GI doc this month for a regularly scheduled visit and the set up a colonoscopy as I am turning 50 and also have a family history of colon issues. This past week I wasn't feeling well (bouts of nausea) and got in to see my pcp and I found out through a blood test my liver enzymes were elevated. I was sent for an abdominal ultrasound and it shows I have an enlarged spleen and  fatty infiltration in the liver. My bloodwork and ultrasound results have been sent to the gastro doc. My question is this what kinds of testing will he do to see why the spleen is enlarged and what about the liver enzymes being elevated. I will see the GI nest week and I am kind of worried about these new developments.

[Kaneda2112]

According to the Mayo clinic - "A number of infections and diseases can contribute to an enlarged spleen. The effects on your spleen may be only temporary, depending on how well your treatment works. Contributing factors include:

    Viral infections, such as mononucleosis
    Bacterial infections, such as syphilis or an infection of your heart's inner lining (endocarditis)
    Parasitic infections, such as malaria
    Cirrhosis and other diseases affecting the liver
    Various types of hemolytic anemia — a condition characterized by premature destruction of red blood cells
    Blood cancers, such as leukemia, and lymphomas, such as Hodgkin's disease
    Metabolic disorders, such as Gaucher's disease and Niemann-Pick disease
    Pressure on the veins in the spleen or liver or a blood clot in these veins

**Tests and diagnosis**

An enlarged spleen is usually detected during a physical exam. Your doctor can often feel the enlargement by gently examining your left upper abdomen, just under your rib cage. However, in some people — especially those who are slender — a healthy, normal-sized spleen can sometimes be felt during an exam.

Your doctor may confirm the diagnosis of an enlarged spleen with one or more of these tests:

    Blood tests, such as a complete blood count to check the number of red blood cells, white blood cells and platelets in your system

    Ultrasound or computerized tomography (CT) scan to help determine the size of your spleen and whether it's crowding other organs

    Magnetic resonance imagining (MRI) to trace blood flow through the spleen

Imaging tests aren't always needed to diagnose an enlarged spleen. But if your doctor recommends imaging, you generally don't need any special preparation for an ultrasound or MRI. If you're having a CT scan, however, you may need to refrain from eating before the test. If you need to prepare, your doctor will let you know well in advance.

Finding the cause

Sometimes you may need further testing to identify what's causing an enlarged spleen, including liver function tests and a bone marrow exam, which can give more detailed information about your blood cells than can blood drawn from a vein.

In some cases, a sample of solid bone marrow is removed in a procedure called a bone marrow biopsy. Or, you may have a bone marrow aspiration, which removes the liquid portion of your marrow. In many cases, both procedures are performed at the same time (bone marrow exam).

Both the liquid and solid bone marrow samples are frequently taken from the same place on the back of one of your hipbones. A needle is inserted into the bone through an incision. Because bone marrow tests cause discomfort, you'll receive either general or local anesthesia before the test.

Because of the risk of bleeding, a needle biopsy of the spleen is almost never done.

Occasionally, when there's no explanation for an enlarged spleen despite a thorough investigation for a cause, your doctor may recommend surgery to remove your spleen. After surgical removal, the spleen is examined under a microscope to check for possible lymphoma of the spleen.
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