What if there is hepatitis B and splenomegaly? Is it harmful?

Spleen enlargement is usually associated with hepatomegaly. Generally, mild splenomegaly is often acute infection, hemolytic anemia, congestive heart failure, leukemia, lymphoma, cirrhosis and rheumatism. Severe splenomegaly is related to sexual infection, severe chemotaxis and parasitic infection (leishmaniasis). Due to the mechanism of lymphocyte proliferation, cancer cell invasion, macrophage increase and blood stagnation, spleen enlargement increases. There are many reasons for splenomegaly, generally speaking, there are five main aspects: 1. Congestive splenomegaly: caused by portal hypertension, it is found in various cirrhosis, portal vein, splenic phlebitis or thrombosis, and late hypersplenism. Second, infectious splenomegaly: 1, acute infectious splenomegaly caused by viral hepatitis and septicemia. Generally, the texture is mild and soft. As the infection is controlled, the spleen gradually shrinks. 2. Spleen abscess is a rare complication such as abdominal purulent infection, sepsis and typhoid fever, accompanied by chills and fever, abdominal muscle tension, spleen tenderness fluctuation and leukocytosis; Fricative sounds can appear in the spleen area when spleen inflammation is complicated, which can be distinguished from left subphrenic abscess and abdominal abscess by ultrasonic examination and radionuclide imaging. Third, reticuloendothelial proliferative splenomegaly: rare in clinic, such as eosinophilic granuloma and malignant histiocytoma. 4. Hematological splenomegaly: 1, chronic leucorrhea with bone marrow fibrosis, chronic hemolytic anemia, splenomegaly is more obvious. 2. Chronic idiopathic thrombocytopenic purpura with unknown causes mostly occurs in young women, characterized by bleeding of skin and mucosa, thrombocytopenia, prolonged bleeding time, normal coagulation time, megakaryocyte increase in bone marrow and poor platelet formation, often accompanied by mild splenomegaly. 5. Tumor splenomegaly: 1. Primary splenic tumor: rare benign hemangioma and lymphangioma with no other symptoms except splenomegaly; Most malignant tumors are sarcoma of the spleen, the spleen swells rapidly, the mass is hard, the surface is not smooth, accompanied by fever and discomfort in the left upper abdomen, and the whole body condition deteriorates in a short time. The road to health II. Spleen cyst: dermoid cyst, lymphoid cyst and hydatid cyst are true cysts, and the intima has secretory function; Pseudocyst can be divided into bloody, serous and inflammatory. The cyst wall is fibrous tissue, which is formed by old hematoma after spleen injury or local necrosis and liquefaction after spleen infarction, and has no secretory function. %D%A Q: %D%A Wow, it's so serious! Can you tell me how to go to the hospital for examination? %D%A Answer: %D%A Diagnosis of splenomegaly by registered diagnosis and treatment in general surgery in regular hospitals: It is of great significance to know the medical history in detail. Attention should be paid to the sequence of onset, duration of disease, past history, epidemic history, family history, age and sex of patients, and accompanying symptoms of splenomegaly. Can provide some clues for diagnosis. Acute infection usually begins with a short acute course of disease, while splenomegaly is a hereditary disease with mild/chronic infection, slow onset and long course of disease. Malignant tumors often develop rapidly and can increase significantly with the extension of the course of disease. Past history is also very helpful for the diagnosis of diseases, such as: past history of viral hepatitis, long-term drinking history or history of blood transfusion and blood products. The existing splenomegaly suggests that it may be chronic hepatitis or portal hypertension due to liver cirrhosis; Epidemics and endemic diseases often have a history of epidemic; Some diseases may have a family history, such as thalassemia and metabolic diseases. The incidence of some diseases is related to age and sex, such as histiocytosis and lipomatosis, which mostly occur in infants; Infectious diseases in acute infectious diseases often occur in teenagers; Malignant histiocytosis, chronic viral hepatitis and cirrhosis are more common in young men and women; Multiple myeloma, more common in elderly men; Leukemia, malignant lymphoma! Can occur at any age; Connective tissue disease mostly occurs in young women and other accompanying symptoms and signs of splenomegaly, which is an important clue to find the cause of splenomegaly. For example, splenomegaly with fever can be seen in various acute and chronic infectious diseases; Spleen enlargement with anemia, fever and bleeding tendency often suggests leukemia splenomegaly; The yellow staining of splenomegaly with anemia suggests hemolytic anemia; Yellow staining of splenomegaly often suggests chronic hepatitis or cirrhosis; Spleen enlargement with digestive tract symptoms or hematemesis and melena may be cirrhosis and portal hypertension; Heart disease or pericardial effusion! Congestion splenomegaly often has symptoms such as dyspnea, palpitation and shortness of breath. Spleen enlargement caused by various diseases has its own characteristics at the same time, which should be asked one by one in the medical history. The physical examination of splenomegaly mainly depends on palpation. When palpation can't confirm the diagnosis, percussion can be used to check whether the voiced boundary of spleen is enlarged. (The normal spleen voiced boundary is between the 9th-11rib of the left axillary midline; The width is 4-7 cm, and the front part does not exceed the front of the armpit. If necessary, people can check the size and shape of the spleen by ultrasonic X-ray and CT. When palpation finds splenomegaly, they should pay attention to the degree and nature of splenomegaly and whether there are other accompanying signs. (1) The degree of splenomegaly is related to the condition. 1 mild splenomegaly is mild when the lower edge of the syndrome is less than 2cm below the costal edge. Can be seen in some viral infections, bacterial infections, rickettsia infections, early schistosomiasis, congestive heart failure, liver cirrhosis, portal hypertension, Hodgkin's disease. Moderate splenomegaly, such as juvenile rheumatoid arthritis, systemic lupus erythematosus, tropical eosinophilia and idiopathic thrombocytopenic purpura, is defined as the lower margin of splenomegaly exceeding 2 cm below the costal margin and not exceeding the umbilical horizontal line and abdominal midline. It can be seen in acute myeloid leukemia, acute lymphoblastic leukemia, chronic hemolytic anemia, infectious mononucleosis, rickets, splenic amyloidosis, malignant lymphoma, Niemann-piccard disease, etc. It can be seen in chronic myeloid leukemia, schistosomiasis, maculopathy, myelofibrosis polycythemia vera, thalassemia, Gaucher's disease and so on. (2) Spleen; The quality of splenomegaly caused by different reasons can change in different degrees. Generally, splenomegaly caused by acute infection is large and soft. Spleen enlargement caused by chronic infection and leukemia cell tumor is hard and uneven; Spleen hardness of liver cirrhosis is moderate; The nature of extravasated splenomegaly varies with extravasation degree and extravasation time. The extravasation is light, the quality is soft for a long time or the extravasation is heavy and hard, but generally there is a feeling of fullness. It must be pointed out that the degree and nature of splenomegaly are different not only because of different causes, but also because of different courses of treatment and individual responsiveness, so we should pay attention to these factors when judging. (3) There are different accompanying signs besides splenomegaly caused by different causes. Hematological splenomegaly shows anemia, bleeding spots or ecchymosis, such as various types of leukemia, idiopathic thrombocytopenic epilepsy, anemia, jaundice, hemolytic anemia, chronic viral hepatitis, cirrhosis, malignant histiocytosis, septicemia, etc. Hepatomegaly and lymphadenopathy are seen in malignant lymphoma, lymphocytic leukemia, connective tissue disease, donated mononucleosis and tuberculosis. Liver diseases, liver palms and spiders are rare in chronic viral hepatitis and cirrhosis. Various types of rashes are common in various infectious diseases or infectious diseases. Such as typhoid fever, brucellosis, septic subacute infective endocarditis, etc. Edema and ascites are found in chronic right heart failure, constrictive pericarditis, liver cirrhosis and portal hypertension with inferior vena cava obstruction. Visceral enlargement is seen in chronic heart failure caused by various heart diseases and a large number of pericardial effusion caused by various reasons. Laboratory examination laboratory examination is of great significance to the diagnosis of splenomegaly, including blood routine, platelet count, reticulocyte count and eosinophil count. Careful blood cell examination is helpful to find pathological blood cells and other abnormal cells. Hemoglobin electrophoresis, erythrocyte fragility test, acid hemolysis, (Ham), direct anti-human globulin (Combs) blood parasite test, liver function test, bone marrow test or bone marrow biopsy serological antigen antibody test; Laboratory tests such as lymph node puncture or biopsy, spleen puncture or biopsy and ascites routine examination can be based on the medical history. After the initial diagnosis, targeted selection can often find the basis for determining the diagnosis of certain diseases. Four. Instrumental examination The necessary instrumental examination is of great diagnostic value in determining the cause of splenomegaly. The commonly used examination method is the old-fashioned ultrasonic examination. We did dynamic examination, X-ray examination, CT examination, magnetic resonance examination and endoscopic venography. The diagnosis steps of splenomegaly can not be separated from the above aspects, but we should have priorities in the thinking process. First determine whether the spleen is big, the degree and nature of spleen is big. The second step is to understand the accompanying symptoms and signs of splenomegaly, usually by understanding the medical history and physical examination; Physical examination can initially diagnose the cause of splenomegaly by knowing the medical history, and then selectively do relevant laboratory tests and necessary instrument tests, and finally make a diagnosis of the cause of splenomegaly. %D%A