Splenomegaly is an enlargement of the spleen. The spleen has to be two and a half times its normal size to become palpable, therefore an enlarged spleen is not always palpable. In ptosis of spleen, it is palpable, though not enlarged.

Signs Suggestive of Enlarged  Spleen

• Predominant left sided abdominal distension
• Splenic mass moves downwards on inspiration
• A notch is felt on the anterior border of spleen
• Left abdominal pain if massive splenomegaly

Causes

Infective:

1. Bacterial: Septicemia, SBE, typhoid, syphilis
2. Viral: Infective hepatitis, infectious mononucleosis
3. Protozoal: Malaria, kala azar, trypanosomiasis
4. Fungal: Histoplasmosis

Congestive

A. Suprahepatic:

1. Congestive cardiac failure
2. Constructive pericarditis
3. Budd Chiari syndrome

B. Hepatic:

1. Cirrhosis
2. Schistosomiasis
3. Sarcoidosis
4. Congenital hepatic fibrosis

C. Intrahepatic: Portal vein thrombosis

Blood Diseases:

1. Polycythemia rubra vera
2. Hemolytic anemia-Thalassemia
3. Leukemias
4. Lymphoma
5. Myelofibrosis

Infiltrative and degenerative disorders

1. Gaucher’s disease
2. Niemann Picks disease

3. Amyloidosis

Neoplastic: Hemangiomas, sarcomas, cysts, metastasis

Miscellaneous:

1. Connective tissue disorders.
2. Rupture of spleen and hematoma.