An enlarged spleen in a child can be concerning for parents. Splenomegaly is the term for this condition, which can result from a number of underlying problems. Knowing what to do next will allay your worries and guarantee that your child receives the necessary care.
The spleen is crucial for preventing infections and cleansing blood. The body’s response to an infection or other medical conditions may be suggested by an enlarged spleen. It’s critical to monitor your child for any additional symptoms, such as pain or unusual fatigue.
The first thing to do if you discover that your child’s spleen is enlarged is to get medical advice. They are capable of carrying out the required examinations to identify the root cause and suggest the best course of action. Any problems can be addressed with early intervention before they worsen.
| Step | Action |
| 1 | Consult a pediatrician to confirm the diagnosis and understand the cause of the enlargement. |
| 2 | Follow the doctor"s recommendations for any necessary tests or imaging. |
| 3 | Monitor the child’s symptoms and keep track of any changes or new symptoms. |
| 4 | Ensure the child maintains a healthy diet and gets proper nutrition. |
| 5 | Ensure the child avoids activities that could potentially impact the spleen. |
| 6 | Schedule follow-up appointments with the pediatrician to track the condition. |
| 7 | Seek immediate medical attention if symptoms worsen or if new symptoms arise. |
- Features
- Age
- Normal sizes
- Causes
- Symptoms
- Diagnostics
- Danger
- Treatment
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Features
The spleen is located in the abdominal cavity. It consists entirely of lymphoid tissue and takes part in immune and other important processes. Although this organ is not vital (a person can live without it), the importance of the spleen for the body is difficult to overestimate. It participates in hematopoiesis, being a direct participant in the creation of lymphocytes. These cells are capable of destroying bacteria and viruses that enter the body, and without them, there is no point in talking about normal immune function. The spleen processes old erythrocytes (red blood cells), and then sends them to the liver, thereby contributing to the production of bile, which is needed for digestion. This organ accumulates platelets. About a third of all platelets are the merit of the spleen. Indirectly, the organ also participates in the hormonal regulation of bone marrow activity.
Age
The spleen begins to appear in the fetus at the earliest stage of pregnancy – 5-6 weeks after fertilization. This process ends by the fifth month of pregnancy. If at this critical stage the fetus is exposed to negative factors (bad habits of the mother, genetic "failures", toxins, acute infection of the expectant mother), then malformations of this organ are possible. Defects are usually of three types – complete absence of the organ or the presence of two or more spleens in one organism, as well as kinks and pinches. In a newborn, the lymphoid organ has a round shape and weighs only about 9 g. By the age of one year, the weight of this organ increases almost threefold and is about 25-28 g. At 7 years old, the spleen in a child weighs more than 50 g, and at 16 years – more than 160 g. The presence of a healthy, normally functioning spleen is very important for childhood, because children are more susceptible to viral and bacterial infections. Without the participation of the spleen, it will be much more difficult to resist diseases.
Normal sizes
The size of the spleen increases as the child grows. To assess the condition of this organ, a table of acceptable sizes is used. It is not entirely correct to start from the age of the child. One-year-olds can have different heights, as well as weights. This means that the size of the spleen will also vary. It is much better to use a table compiled by pediatricians and approved by the Ministry of Health, which is based on possible sizes for a particular child"s height. As you can see, the range of normal sizes varies quite widely. An error of five to six mm is quite normal fluctuations. Normal sizes should not differ too much from those presented in the table. Any increase in the area of the spleen (by 15% of the norm or more) in an infant, preschooler or schoolchild should necessarily be the basis for a medical diagnosis.
Causes
- bacterial infections, including severe ones – sepsis or typhoid fever;
- hematopoietic diseases;
- liver pathologies (cirrhosis, cystic fibrosis and others);
- severe chronic diseases – tuberculosis, syphilis;
- metabolic diseases;
- cardiovascular defects;
- oncological diagnoses;
- benign tumors and formations, as well as cysts of the spleen itself.
The spleen itself can experience a variety of disorders in a child’s body, nearly all of which are accompanied by an expansion of the lymphoid organ:
- splenic infarction;
- abscesses (abscesses) in the cavity of the organ;
- inflammation of the organ;
- paralysis of the muscular apparatus of the spleen.
There are certain illnesses that are without a doubt the most common causes of splenomegaly in children. Acute viral diseases include mononucleosis, herpes infection, chickenpox, rubella, measles, and so forth. In second place are metabolic issues that run in families.
It is common to have intestinal and liver parasitic lesions (from certain helminth species). Here, the spleen "reacts" to the issue with an excruciating increase right away.
Determining the cause of splenomegaly is crucial because without it, appropriate treatment cannot be administered. After all, the goal of treatment is to eradicate the illness that fuels the spleen’s growth rather than shrink it. The spleen will then start to diminish on its own.
It should be recognized that carrying out official duties literally causes the organ to suffer. The increase happens when the body’s immune burden rises noticeably, which is precisely what happens during illnesses.
Fungal infections can occasionally be the cause of a pathological enlargement of an organ. Usually, this affects the skin on the hands and face, as well as the lungs.
Symptoms
One cannot make a snap judgment that a child has an enlarged spleen. Typically, there are no clinical symptoms associated with the splenomegaly process itself. Symptoms of other diseases that were secondary to the enlarged spleen may cause the child great distress. Typically, splenomegaly is only disclosed to parents during an examination:
- For the inflammatory process in the spleen, such manifestations as frequent and rather prolonged diarrhea, slight nausea and episodic vomiting, pain under the ribs, increased body temperature are characteristic.
- Non-inflammatory processes in the spleen rarely cause pain upon palpation. The temperature also usually remains normal. The skin in pathologies associated with an enlarged spleen may be pale, the child may become more tired, apathetic. Excessive sweating may be observed at night.
However, because all of these symptoms are ambiguous and indirect, a specific diagnosis cannot be made in this case based solely on the collection of symptoms.
The spleen may enlarge, but the child may not experience any negative symptoms. This also occurs frequently.
Diagnostics
The technique of palpating the spleen does not yield much information. This organ is essentially unpalpable in teenagers, and in small children, a small size excess is occasionally even the norm.
Ultrasound diagnostics is the primary diagnostic technique that enables us to determine the spleen’s size as well as its structure, the existence of cysts, tumors, and potential abscesses. Initially, the doctor will have you have an ultrasound of your abdominal organs.
But the measurements taken by the diagnostician with an ultrasound scanner by itself do not serve as the foundation for a choice. Additionally, the child must take tests:
- general blood test;
- complete blood count;
- general urine test;
- stool test.
Sometimes seeing a hematologist and undergoing a CT scan are required to obtain a full picture.
Danger
By itself, splenomegaly is not very harmful. Far more serious is the underlying illness that resulted in the spleen enlargement.
Given that a child’s body is undergoing rapid growth, a large increase in the spleen puts pressure on the stomach and other nearby organs. Metabolic and digestive processes are interfered with.
Anemia may range from a basic hemoglobin deficiency to more serious diagnoses if the spleen is malfunctioning. The most hazardous is the onset of hypersplenism, which is characterized by the spleen’s massive destruction of blood cells. Leukopenia (when leukocytes die), thrombocytopenia (when platelets die), and anemia (when red blood cells and oxygen-carrying proteins die) are classified according to which cells die the most.
The primary risk is rupture and subsequent bleeding into the abdominal cavity if the spleen itself has growths, cysts, or venous blood stasis.
It’s critical to recognize that an enlarged spleen in your child may indicate a number of different health problems, from infections to more serious disorders. Seeking a pediatrician for a comprehensive assessment to identify the root cause is the first step. Treatment options may include medication, lifestyle modifications, or ongoing care to effectively manage the condition, depending on the diagnosis. Taking quick action to treat an enlarged spleen can help protect your child’s health and wellbeing.
Treatment
After finding an enlarged spleen in a newborn, the physician will not make any snap decisions. The degree of blood circulation in infants directly affects the size of the spleen; the more blood that fills the organ, the larger it is.
Splenomegaly necessitates medical attention in all other cases. By the time a treatment plan is recommended, the doctor will have precisely identified the disease that is causing the symptoms, as the purpose of diagnostics is not so much to measure the size of the spleen as to identify the underlying cause of its pathological growth.
The underlying disease will be the focus of the doctors’ efforts. Antibiotic therapy will be recommended if splenomegaly is brought on by a bacterial infection or a severe inflammatory response brought on by microorganisms.
Depending on the size and location of the tumor, diseases linked to it may be treated with surgery or antitumor drugs. Vitamin therapy is always added by doctors. Immunosuppressants, or medications that reduce immune system activity, are prescribed for autoimmune causes of splenomegaly.
Generally, a conservative approach can be successfully used to solve the issue. A decision to remove the spleen may be made if it does not shrink in size as the patient recovers from treatment for the underlying disease or if the organ appears to be growing.
When a patient has lymphogranulomatosis, a cancerous disease of the lymphoid tissue, or when their spleen is so large and their tissues are so thin that there is a chance of an abrupt organ rupture, the spleen is removed right away (without any prior medical intervention).
Splenectomy, or the excision of the kidney. The laparoscopic approach is most frequently used for children, as it is the most benign, virtually bloodless, and advantageous (in terms of future recovery). Other surgical techniques exist as well, but they all entail making a direct incision in the peritoneum to gain direct access to the spleen.
Following surgery, the child’s immunity drastically drops, making them more vulnerable to infections of both bacterial and viral origin. It is especially vulnerable to bacteria, which is why children who have had splenic surgery must have vaccinations against meningococcus, pneumococcus, and Haemophilus influenzae as part of their personal plan.
It should be mentioned that the immune system will only temporarily decline because, in most cases, the body can heal itself after losing an organ in one to two years.
The child’s life will be quite full and free from major constraints, and he will get sick far less frequently.
When learning that your child has an enlarged spleen, it’s critical to maintain composure and take the necessary action to address the condition. Numerous things, such as injuries, infections, or underlying medical conditions, can result in enlarged spleens. See your child’s pediatrician as soon as possible. They can identify the cause and suggest the best course of action.
To identify the underlying cause, your doctor may recommend a variety of tests or imaging procedures. The options for treatment will change based on the diagnosis. In certain situations, more specialized treatments may be required, or it may be as simple as keeping an eye on the condition with routine checkups. Always heed the advice of your physician, and schedule any necessary follow-up visits.
Meanwhile, you can promote your child’s general wellbeing by making sure they get enough sleep and eat a balanced diet. Steer clear of activities like contact sports that could further tax the spleen. Maintaining open lines of communication with your healthcare provider will facilitate your child’s recovery and help manage the condition more successfully.
