Any deviation from the norms in the development of internal organs in a child alarms and frightens parents. Quite often, mothers and fathers have to hear from the doctor that the child has an enlarged spleen. After reading this article, you will find out what this may mean, what to do if a child has an enlarged spleen.
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 a vital one (a person can live without it), it is difficult to overestimate the importance of the spleen for the body. She 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 need to talk about the normal functioning of immunity. The spleen processes old red blood cells (red blood cells), and then sends them to the liver, thereby contributing to the production of bile, which is needed for digestion.
This organ stores platelets. About a third of all platelets are due to the spleen. The organ also indirectly participates in the hormonal regulation of the activity of the bone marrow.
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 affected by negative factors (bad habits of the mother, genetic "failures", toxins, an acute infection, which the expectant mother fell ill with), then malformations of this organ are possible. Vices are usually of three types - complete absence of an organ or the presence of two or more spleens at once in one organismas well as kinks and pinches.
In a newborn, the lymphoid organ has a rounded shape and weighs only about 9 g. Already by the year of life, the weight of this organ increases almost three times and is about 25-28 g. At 7 years old, the child's spleen weighs more than 50 g, and at 16 years old - more than 160 g.
Having 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 disease.
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. Years of the same age can have different heights, as well as weight. This means that the size of the spleen will differ.
It is much better to use a table compiled by pediatricians and approved by the Ministry of Health, which starts from the possible sizes for a particular child's height. As you can see, the size range normally fluctuates quite widely. An error of five to six mm is quite normal fluctuations.
Normally, the dimensions 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 must necessarily become the basis for medical diagnosis.
Causes
If a child has an enlarged spleen, doctors talk about such a phenomenon as splenomegaly. Spontaneous primary diseases of the spleen are rare. Usually, this organ increases in size with certain diseases, this is only one of the symptoms of the underlying ailment.
The list of possible causes of splenomegaly is very extensive:
- infections of bacterial origin, including severe ones - sepsis or typhoid fever;
- diseases of hematopoiesis;
- liver pathologies (cirrhosis, cystic fibrosis, and others);
- severe chronic diseases - tuberculosis, syphilis;
- metabolic diseases;
- defects of the cardiovascular system;
- oncological diagnoses;
- benign tumors and formations, as well as cysts of the spleen itself.
The spleen itself, with various pathologies in the child's body, can undergo different conditions, almost all of them are accompanied by an increase in the size of the lymphoid organ:
- spleen infarction;
- abscesses (abscesses) in the organ cavity;
- organ inflammation;
- paralysis of the muscular system of the spleen.
There are diseases that are the undisputed leaders among the possible causes of splenomegaly in children. These are acute viral diseases: measles, rubella, chickenpox, mononucleosis, herpes infection, and so on. In second place are hereditary metabolic problems.
Often there is also parasitic damage to the liver and intestines (some types of helminths). In this case, the spleen immediately "reacts" to the problem with painful enlargement.
Finding the cause of splenomegaly is very important; without this, proper treatment is impossible. After all, therapy is not based on shrinking the spleen, but on eliminating the disease that causes it to grow. After that, the spleen will shrink by itself.
It should be understood that the body suffers literally in the line of duty. The increase occurs when the immune load on the body increases significantly, and this is what happens in the process of disease.
Sometimes the cause of the pathological enlargement of the organ lies in a fungal infection. In this case, both the lungs and the skin of the face and hands are usually affected.
Symptoms
It is impossible to quickly guess that the child has an enlarged spleen. Usually the process of splenomegaly itself does not cause any clinical symptoms. The child may suffer from manifestations of other diseases that were primary in relation to an enlarged spleen. Usually, parents learn about splenomegaly only during the examination:
- For the inflammatory process the spleen is characterized by such manifestations as frequent and rather prolonged diarrhea, slight nausea and episodic vomiting, pain under the ribs, and fever.
- Non-inflammatory processes in the spleen rarely cause pain on 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 occur at night.
However, all these signs are indirect, ambiguous, and it is not possible to make this or that diagnosis based on the totality of symptoms in this case.
The child may not feel anything bad, but the spleen may be enlarged. This also happens quite often.
Diagnostics
With the help of the method of palpation of the spleen, much information cannot be obtained. In adolescents, this organ is practically not palpable, and in young children, a slight excess in size is sometimes generally the norm.
The main diagnostic method, which allows one to judge not only the size of the spleen, but also its structure, the presence of possible abscesses, cysts and tumors, is ultrasound diagnostics. The doctor will send an ultrasound of the abdominal organs first.
However, only the measurements of a diagnostician using an ultrasound scanner are not the basis for a decision. The child will also have to pass tests:
- general blood analysis;
- detailed blood test;
- general urine analysis;
- stool analysis.
In order for the picture to be complete, sometimes there is a need to undergo computed tomography and visit a hematologist.
The danger
Splenomegaly itself is not that dangerous. A much greater danger is the underlying disease that caused the enlargement of the spleen.
With regard to the child's body, which is in a state of intensive growth, a significant increase in the spleen leads to pressure on neighboring organs, including the stomach. Digestion is impaired, as well as metabolic processes.
If the spleen is not working properly, then problems with blood are not excluded - from simple hemoglobin deficiency to more serious diagnoses. The most dangerous is the development of hypersplenism - the massive destruction of blood cells in the spleen. Depending on which cells die the most, there are leukopenia (with the death of leukocytes), thrombocytopenia (with the death of platelets) and anemia (with the death of erythrocytes and oxygen-carrying proteins).
If in the spleen itself there are stagnations of venous blood, cysts and formations that are prone to growth, then the main risk is rupture and subsequent hemorrhage into the abdominal cavity.
Treatment
Having discovered an enlarged spleen in a newborn baby, the doctor will not rush to conclusions. In infants, the size of the spleen is directly related to how intensively the blood circulation is carried out - the more the organ is filled with blood, the larger its size.
In all other cases, with splenomegaly, medical attention is required. Since the diagnosis is carried out not so much to determine the size of the spleen, but to find the true cause of its pathological growth, by the time the treatment is prescribed, the doctor will know exactly what disease caused the symptoms.
The efforts of doctors will be aimed at treating the underlying ailment. If splenomegaly is based on bacterial infection or a strong inflammatory process caused by microbes, then a course of antibiotic treatment will be prescribed.
Diseases associated with tumors will be treated depending on the size and location of the tumor - antitumor drugs or surgery. Doctors always add vitamin therapy. For autoimmune causes of splenomegaly, immunosuppressants are prescribed - drugs that suppress the activity of the immune system.
As a rule, it is possible to successfully solve the problem in a conservative way. If, during the treatment of the underlying disease, the size of the spleen does not decrease as it recovers, if there is a tendency for further growth of the organ, then a decision may be made to remove it.
The spleen is removed immediately (without prior treatment) with lymphogranulomatosis - a malignant disease of lymphoid tissue, and also almost always when its size is so large, and the tissue is so thinned that there is a risk of sudden rupture of the organ.
Spleen excision surgery - splenectomy. Most often, it is performed for children by the laparoscopic method, which is the most gentle, almost bloodless and favorable (in terms of further recovery). There are also other methods of surgical intervention, but they are all associated with direct access to the spleen through a direct incision of the peritoneum.
After the operation, the child's immunity decreases sharply, the baby becomes extremely susceptible to infections - both bacterial and viral origin. Bacteria are a particular danger to him, therefore, after surgery to remove the spleen, children must be introduced into a personal plan vaccinations against meningococcus, pneumococcus and Haemophilus influenzae.
It should be noted that the decrease in immunity will be temporary, usually the body manages to compensate for the absence of an organ in one and a half to two years.
The child will get sick much less often, his life will be completely full, without significant restrictions.
Prevention
There is no specific prevention of spleen problems, but there is measures to help protect the child from pathological enlargement of this organ:
- The baby needs to be vaccinated on time and in full from the very birth... Refusal of vaccinations increases the risks of contracting dangerous infections, which the child's body simply cannot cope with without damage to the spleen.
- If you plan to travel to distant exotic countries, be sure to ask on the Rospotrebnadzor website what specific diseases are common at the destination.
The child will need to be vaccinated in advance. Such vaccines (for example, against malaria) are not included in the national immunization schedule. They are made in private clinics - at their own expense.
- If the child is engaged in active or strength sports, you need to explain to him the harm from excessive physical exertion. Understanding this can save the child from traumatic rupture of the spleen.
- Teenagers should stop smoking and drinking alcoholbecause such bad habits increase the load on the spleen. Its increase can develop even from ARVI.
- The child must visit the pediatrician on time, it is not worth giving up planned receptions. Early diagnosis of problems with an enlarged spleen will allow you to quickly cure the underlying disease and preserve the organ.
