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Avatar universal

enlarged spleen 7 months unexplained?

My symptoms all started when I had my third c-section in November of last year. Everything went fine with pregnancy, but after the c-section I had sever menstral bleeding and stomach cramps. I went to the ER numberous occasions for pain. They could never find anything out of the ordinary. Finally in March 08 my OB did a laproscopy to see if they could find anything. They found sever scar tissue wrapped around my bladder and uterus and removed it. But did not find the cause, the pain was more sever then before so the OB went in again in April 08 and found endomitriosis. New symptoms started appearing everything smelling bad, dizziness, Migrains (on one side of the head at a time starting from the back of the head crawling up to behind the eye), inability to hold bladder, nausea, felt like I was swallowing a rock everytime I swallowed, excessive weight gain, pain under my rib cage left side, inablitiy to concentrate, fatigue (could sleep all day if I wanted to), weakness in my legs and arms, neck pain. Found out the pain under left rib cage is a swollen spleen (no doctor can figure out why). Has been swollen twice the size of a normal spleen since February 08. No sign of sickness. Went to a Reumatologist (have been checked for all soft tissue diseases) and auto immune disorders. In April I receive Depo provera shot, seems that is when the Migrains may have started, and aslo the throat swelling. on 4/27/2008 went to the hospital for sever migrain and was given Tramadol, Benadryl and Compazine (seemed to help a little, just wanted to go home.) Went home and went to bed, 15 hours later woke up with a little headache, drank some coffee, felt like my throat was burning (like I was getting a sore throat), then my nose started closing up, had a hard time catching my breath, (called an ambulance after the tongue was swollen). This all happened within 15 minutes. Here is the report from the ER Visit we still can not figure out what happened I went to an allergist and am not allergic to the coffee.

Neurologic Status- The patient had remained alert, oriented, and with a non focal exam. She had been complaining of a new onset of headaches approximately one to two days prior to admission which had peristed. She had been seen in the emergency room as previously outlined. Because of ongoing headaches, a head CT was performed which showed cerebellar tonsillar ectopia consistent with a borderline Chiari I morphology without evidence of hydrocephalus or significant deformity of the cervicomedullary junction or upper cervical cord. There was a mild prominence of subarachnoid space of the cranial vertex.  No subdural collectons noted. Because of the changes seen on th CT, an MRI of the brain was preformed. There was mildly prominent subarachnoid spaces overlaying the cervical convexities bilaterally. This likely represents a normal anatomic variant.There is tonsillar ectopia measuring up to 1 cm without evidence of associatedhydrocephalus. There is no evidence of dural thickening or enhancement. The study was otherwise unremarkable.

Pulmonary Status –The patient had acute tongue and throat swelling. She was examined in the emergency room and had minimal swelling and bogginess of the tongue and the uvula. The etiology of the angiodema was not clear but she had drank coffee. The patient did not have any other exposures that she could recall. She did receive medications in the ER The day before.

Cardivascular status The patient initially was tachycardic after receiving subcu epi. Her hemodynamics improved and were stable throughout the hospital course.

GI- The patient has cronic abdominal pain in part felt to be secondary to endometriosis. She is on chronic narcotics. Her outpatient medication regimen was started with the exception of NSAIDs which could potentially cause angiodema. The patient will follow up with he primary care physician.

5. GU Renal function remains stable.

Endocrine. No acute endocrine issues.

Infection Disease- As part of admission to the ICU, a nasal swab was obtained for MRSA. The patient did have a positive for MRSA. No signs or symptons of active infection.

Well this is the report I have been seeking answers from all sorts of specialist to find out what is exactly wrong with me. The only thing that is consistent in the blood tests is reactive lymphocytes of 7. I just seem to be getting more fatigued and a migrain atleast once a week. I need some help please let me know what you think of this??
9 Responses
563773 tn?1374250139
MEDICAL PROFESSIONAL
Hello,

Your CT head reads tonsillar ectopia of the cerebellum. In tonsillar herniation, also called downward cerebellar herniation, the cerebellar tonsils move downward through the foramen magnum possibly causing compression of the lower brainstem and upper cervical spinal cord as they pass through the foramen magnum. Increased pressure on the brainstem can result in dysfunction of the centers in the brain responsible for controlling respiratory and cardiac function.

For further evaluation of tonsillar herniation, CINE flow studies are suggested. This type of MRI will look at the flow of CSF at the cranio-cervical joint.
http://en.wikipedia.org/wiki/Brain_herniation

Spleen enlargement(splenomegaly) is found in infections,diseases of the liver,hemolytic anemias,cancers and sarcoidosis and sickle cell anemia.pls discuss these options with your doctor to confirm a cause for splenic enlargement.

Abdominal pain and nausea can be attributed to endometriosis.pain in limbs and weakness can be due to chronic fatigue syndrome.Pls discuss these possibilities with your doctor.

Hope it helps.Take care and regards..

Avatar universal
Thank you for the help.
Avatar universal
Well I was really concerned about my migrains and how I have been feeling, the Ct scans and the tonsillar ectopia. I have brought these concerns to my doctor and he pretty much has told me that I am a hyprocondriat and I it is all in my head and put me on depression medication. My question is, if it is all in my head why is this showing up in my scans? Should I give up and realize this is just how I am going to feel forever or seek more help?
563773 tn?1374250139
MEDICAL PROFESSIONAL
Hello,

If lab investigations and radiologic studies are showing up in the reports,then it is diificult to say that the symptoms are only functional and the patient is not having any disorder.I feel that taking a second opinion from another neurologist might help.A psychiatric evaluation on whether all these symptoms are functional will also prove helpful.

Take care and pls do keep me posted on how you are doing.Good luck.
Avatar universal
Do you know if it could be normal to have a spleen enlarged for over 7 months?
563773 tn?1374250139
MEDICAL PROFESSIONAL
Hello,

Splenomegaly or enlarged spleen is not normal. An enlarged spleen (splenomegaly) is not a disease in itself but the result of an underlying disorder.

The possible causes of an enlarged spleen is long, but can include infections, liver disease, blood disorder like anemias, cancer (i.e. lymphoma), infection, or problems with the spleen.

It is important to find out the underlying pathology in which the spleen is enlarged. An enlarged spleen traps and stores an excessive number of blood cells and substances that help blood to clot (platelets). This may clog the spleen and interfere with its ability to function. Eventually, an enlarged spleen is at risk of rupturing. A ruptured spleen can cause life-threatening bleeding into the abdominal cavity.

I feel that an evaluation by a hematologist is mandatory for finding out the cause of enlarged spleen.

Hope it helps.Take care and pls do keep me posted on how you are doing.

Avatar universal
I saw a hematologist and she did some blood work and sees signs of lymphoma. They are doing more blood work and I will see her in a week. Can migrains be related to lymphoma?
Thanks
Leanne
563773 tn?1374250139
MEDICAL PROFESSIONAL
Hello,

Lymphoma is a type of cancer involving cells of the immune system, called lymphocytes.It is usually of two types depending on the type of cells involved;hodgkin’s and non-hodgkin’s lymphoma.I don’t feel that lymphoma can precipitate migraine headaches.No relation has been proved so far.Other triggers for migraine headaches include environmental factors,emotional state of the person,certain foods,light,smells and hormone changes.For more information about the triggers of migraine,pls log on to the following website:
http://www.migrainehelp.com/2.understanding_migraine/2.4.triggers/2.4.1.migraine_triggers.html

Hope it helps.Take care and pls do keep me posted if you have any additional queries.

Avatar universal
The hemotologist saw me, ran some blood work. Did not find anything concerning about lymphoma feels my spleen is fine. I just underwent a LAVH for endometriosis. Had my OBGYN check out my spleen while he is in there.. He found Adherense of omentum to spleen. He told me this is what could be causing my pain. And it could be caused from Trauma or infection of some type. I have searched online and can not find much on how this is a problem... If you have any information please let me know. The doctor took a picture so I could show the hemotologist.
Thank you
Leanne
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