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Saturday, October 22, 2022

Splenomegaly

EM@3AM - By Elizabeth Adams - October 22, 2022
Reviewed by: Sophia Görgens, Cassandra Mackey and Alex Koyfman
Take-home Points: 
  • Bedside ultrasound in combination with physical exam is more sensitive for identifying splenomegaly compared to physical exam alone.
  • The differential diagnosis for splenomegaly is broad but can be simplified into 3 main groups: 1) increased vascular pressure; 2) hemolysis of blood; 3) infiltration by cells/material.
  • Management of splenomegaly in the emergency department is centered on initial testing to identify possible underlying causes and appropriate determination of the need for expedited inpatient workup versus outpatient workup and possible referral to hematology.
  • Undiagnosed splenomegaly can lead to a delay in diagnosis of the underlying condition or potential splenic rupture, particularly in those involved in contact sports.