Splenomegaly is a common finding in patients with liver cirrhosis, but its relationship with portal hypertension has not been clarified yet. Indeed, in portal hypertension, spleen enlargement is not only caused by portal and splenic vein congestion, but it is mainly due to tissue hyperplasia and fibrosis. The increase in spleen size is followed by an increase in splenic blood flow, which actively congests the portal system. The increased splenic blood flow takes part in the increased splanchnic inflow of the hyperdynamic circulatory syndrome that characterizes patients with cirrhosis and portal hypertension. Splenomegaly is often associated with hypersplenism, a clinical syndrome characterized by anemia and a decrease in neutrophil granulocytes and platelets counts. Splenectomy is the traditional surgical therapy for hypersplenism, but it is not commonly recommended in patients with cirrhosis and portal hypertension, because in these patients the surgical procedure is affected by a higher incidence of complications. Recently, a few studies have suggested a new role of the spleen in the pathogenesis of portal hypertension, as they demonstrated an active splenic production of endothelin and carbon monoxide, which are two substances involved in the pathogenesis of this condition.

Spleen and liver cirrhosis: relationship between spleen enlargement and portal hypertension in patients with cirrhosis.

BOLOGNESI, MASSIMO;
2005

Abstract

Splenomegaly is a common finding in patients with liver cirrhosis, but its relationship with portal hypertension has not been clarified yet. Indeed, in portal hypertension, spleen enlargement is not only caused by portal and splenic vein congestion, but it is mainly due to tissue hyperplasia and fibrosis. The increase in spleen size is followed by an increase in splenic blood flow, which actively congests the portal system. The increased splenic blood flow takes part in the increased splanchnic inflow of the hyperdynamic circulatory syndrome that characterizes patients with cirrhosis and portal hypertension. Splenomegaly is often associated with hypersplenism, a clinical syndrome characterized by anemia and a decrease in neutrophil granulocytes and platelets counts. Splenectomy is the traditional surgical therapy for hypersplenism, but it is not commonly recommended in patients with cirrhosis and portal hypertension, because in these patients the surgical procedure is affected by a higher incidence of complications. Recently, a few studies have suggested a new role of the spleen in the pathogenesis of portal hypertension, as they demonstrated an active splenic production of endothelin and carbon monoxide, which are two substances involved in the pathogenesis of this condition.
2005
New Developments in Liver Cirrhosis Research
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/1471958
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