Splenomegaly in children

Abstract

Background: Splenomegaly occurs when the size of the spleen is increased by cells or tissue components or by vascular engorgement. In childhood, it is generally first suspected upon physical examination. The aim of the present study was to find out the prevalence and possible cause of splenomegaly in children admitted in pediatric ward and NICU at tertiary care center.Methods: In this study, total 124 children of age between 0-12 years with clinically palpable splenomegaly, admitted to the wards were studied during the period of 18 months. A detailed history, thorough clinical and all relevant investigation was done. The enlargement of the spleen was graded as per Hacketts and conventional classification. The prevalence, cause of splenomegaly and outcome of the study was noted.Results: The prevalence of splenomegaly was 1.46%. Most common grade of splenomegaly was grade III (33%) of Hackett’s classification. The most common presenting symptom was fever (75%) and sign was pallor (97%). Most common cause of splenomegaly was hemolytic anemia (80.64%) among which thalasemia was 50% followed by sickle cell anemia 30.64%. Out of 124 patients, 123 (99.1%) received medical treatment while only one patient (0.9%) underwent surgical treatment. Among medically treated patients 18 (14.5%) were recovered completely while 100 (80.6%) improved and 4 (3.2%) stable and two patients were (1.6%) died.Conclusions: In patient with grade III, IV, and V of splenomegaly is more likely to have hemolytic anemia as common etiology and hematological investigation should be given more emphasis in a case of splenomegaly.