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1-Infective causes:

  • Bacterial (Typhoid & paratyphoid, septicemia, pyogenic abscess, tuberculosis, typhus).
  • Viral (infective hepatitis, infectious mononucleosis).
  • Spirochaetal (Weirs disease, syphilis)
  • Parasitic (Bilhariziasis, hydatid cyst, malaria,trypanosomiasis, kala azar).

2-Blood diseases:

  •  Leukaemias.
  • Haemolytic anaemias (Spherocytosis, Cooley's anaemia, acquired
  • haemolytic anaemia, hypersplenism).
  • Pernicious anaemia.
  • Polycythaemia rubra vera.
  • ldiopathic thrombocytopenic purpura.

3-Congestive splenomegaly:

  • Due to portal hypertension.

4-Metabolic:

  • Gaucher's disease, amyloidosis, porphyria, rickets.

5-Tumors:

  • Hemangioma, fibrosarcoma, lymphomas (commonest cause of neoplastic enlargement of spleen).

6-Non parasitic cysts

7-Collagen diseases:

  • Felty's syndrome and Still's disease.

Huge splenomegaly

its enlarged spleen crossing the umbilicus.
 Causes of huge splenomegaly:
  • Bilharzias
  • chronic myeloid leukemia
  • chronic malaria- Kala Azar
  • thalassemia major
  • myelofibrosis
  • amyloidosis
  • Gaucher's disease

Bilharzial splenomegaly:

Causes of splenomegaly in belharziasis
  • Hyperplasia of RES due to absorption of Bilharzial toxins.
  • Bilharziasis ) periportalfibrosis ) portal hypertension ) congestive Splenomegaly.

Treatment:
Splenectomy in patients with hepatosplenomegaly is indicated only in the following conditions:
1- Hypersplenism.
2- Huge splenomegaly.
3- Recurrent attacks of pain 2ry to splenic infarctions.
4- As a part of operations done for portal hypertension.
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