Hypersplenism and coagulopathy

Abstract:

Hypersplenism is a syndrome consisting of splenomegaly, peripheral blood cytopenia involving one or more cell lines and manifesting as anaemia, thrombocytopaenia and leukopaenia, and normal bone marrow cellularity or compensatory hyperplasia of all cell lines whose peripheral count is reduced. In addition to coagulation disorders, frequent complications of liver diseases, especially cirrhosis, are qualitative and quantitative changes in platelets. Thrombocytopaenia is considered to be the most common manifestation of hypersplenism, playing an important role in bleeding commonly associated with portal hypertension. Mild to moderate splenomegaly is usually asymptomatic. The patients may complain of pressure in the left upper abdominal quadrant as a consequence of enlarged spleen. Bleeding as one of the signs of liver disease may be mild, moderate or severe. Treatment of hypersplenism is directed at treating the primary disease. Coagulation disorder treatment in liver patients is indicated only in cases of manifest bleeding or prevention of bleeding during invasive diagnostic or therapeutic interventions. 

Key words:
hypersplenism; hypersplenism, diagnosis; hypersplenism, therapy; splenomegaly; thrombocytopenia