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Gastroenterology (Expert Forum)
Liver § Spleen both enlarged?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Liver § Spleen both enlarged?
by HeyItsVickie, Jan 10, 2005 12:00AM
Hi Doctor, I'm 34, slim and rarely have a sip of alcohol. My GB was removed in Jan. 04. Day's after and months to follow I would throw up liver bile. Which lead me back to the G.I. whose done a couple of colon/endoscopys these passed 12 months. He's found 3 ulcers, a roid, severe gastritis due to the puddle of bile sittin on my stomach. In November, I was still complaining of vomiting bile and upper right side pain. He ordered an MRCP and learned that my liver measured 20cm. 2 hepatic cysts and 1 renal cyst. I was hospitalized over the holidays because of an "episode" so to speak, where I would vomit endlessly and crunching over in pain. An U/S was ordered, reconfirming the liver size and then learning that the spleen was also enlarged.
My liver function panels are normal. No Hepatitis, no fatty liver. My platelets are slightly abnormal, meaning low. I'm set up for a liver biopsy on the 18th.
But, my question is...after all these tests and bloodwork coming back almost normal, what could be wrong with me? I ask my doctor, but he won't spit it out, he says he's not sure. But, c'mon? Just a "general" idea at this point would give me some peace.
Thank you!
Victoria
My liver function panels are normal. No Hepatitis, no fatty liver. My platelets are slightly abnormal, meaning low. I'm set up for a liver biopsy on the 18th.
But, my question is...after all these tests and bloodwork coming back almost normal, what could be wrong with me? I ask my doctor, but he won't spit it out, he says he's not sure. But, c'mon? Just a "general" idea at this point would give me some peace.
Thank you!
Victoria
Doctor's Answer
by Kevin Pho, MD, Jan 11, 2005 12:00AM
, Jan 11, 2005 12:00AM
There are various causes that can enlarge the spleen. This can include the following (via UptoDate):
Liver disease — 33 percent (cirrhosis)
Hematologic malignancy — 27 percent (lymphoma)
Infection — 23 percent (AIDS, endocarditis)
Congestion or inflammation — 8 percent (congestive heart failure)
Primary splenic disease — 4 percent (splenic vein thrombosis)
Other or unknown — 5 percent
I agree with the current course of action - the liver biopsy to rule out cirrhosis would be a reasonable approach (since this can certainly cause the spleen the enlarge).
If negative, you may want to consider a hematology evaluation to look for blood disorders that can enlarge the spleen.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Bibliography:
Landaw. Approach to the patient with splenomegaly. UptoDate, 2005.
Liver disease — 33 percent (cirrhosis)
Hematologic malignancy — 27 percent (lymphoma)
Infection — 23 percent (AIDS, endocarditis)
Congestion or inflammation — 8 percent (congestive heart failure)
Primary splenic disease — 4 percent (splenic vein thrombosis)
Other or unknown — 5 percent
I agree with the current course of action - the liver biopsy to rule out cirrhosis would be a reasonable approach (since this can certainly cause the spleen the enlarge).
If negative, you may want to consider a hematology evaluation to look for blood disorders that can enlarge the spleen.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Bibliography:
Landaw. Approach to the patient with splenomegaly. UptoDate, 2005.
