The spleen normally lies along the long axis of the 10th rib. Its lower pole extends forward as far as the midaxillary line.
Causes of splenomegaly include:
- Polycythaemia vera
- Leukaemias, especially CML
- Haemolytic conditions
- Hereditary spherocytosis
- Mycobacterium avium complex
- Infectious mononucleosis
- Splenomegaly of portal hypertension
- Liver cirrhosis
- Hepatic and splenic vein obstructions
Diseases in which splenomegaly if present is most likely to be massive are:
However, the commonest cause of massive splenomegaly in a large study in America was chronic liver disease.
O’Reilly, R. Splenomegaly in 2,505 patients at a large university medical center from 1913 ro 1995. 1963 to 1995: 449 patients. West J Med. 1998; 169(2): 88-97.