Is it okay not to remove the spleen for cirrhosis with splenomegaly?

Written by Yang Chun Guang
Gastroenterology
Updated on September 26, 2024
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Once cirrhosis patients are found to have splenic hyperfunction, in order to reduce the splenic hyperfunction and its phagocytic destruction of red blood cells, white blood cells, and platelets, the spleen must be dealt with. Traditionally, the treatment plan could involve surgically removing the spleen, also known as splenectomy. However, current treatment plans generally involve interventional methods. After multiple interventional embolizations, the spleen undergoes aseptic necrosis and is absorbed, thus improving the condition of splenic hyperfunction. Therefore, now in cases of cirrhosis with splenic hyperfunction, it is possible to treat without removing the spleen, using interventional methods instead.

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Written by Wu Hai Wu
Gastroenterology
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Is the pain obvious in the early stages of cirrhosis?

In the early stages of cirrhosis, the pain is not very obvious. Patients in the early stages of cirrhosis may experience vague discomfort in the upper right abdomen, while others may never experience pain at all. Those in the early stages may also have symptoms such as belching, fatigue, acid reflux, jaundice, and dark urine. Further comprehensive auxiliary examinations are needed, such as liver function tests and abdominal imaging studies. At the same time, it is important to identify the cause of early-stage cirrhosis in patients as soon as possible and adopt appropriate treatment measures based on different causes. For instance, if it is caused by alcohol, then treatment should involve abstaining from alcohol.

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Why does cirrhosis cause increasing weight loss and what can be done about it?

The reason why patients with cirrhosis are becoming thinner might be due to the decreased protein synthesis function of the liver after cirrhosis, leading to progressively lesser protein in the body, which results in the patient becoming thinner. It could also be because cirrhosis leads to poor digestion and absorption in patients, thereby reducing their absorption capacity and causing them to lose weight. Under these circumstances, some medications can be used for treatment, such as the infusion of albumin to supplement plasma proteins in the body. It is also important to actively treat the underlying cause of cirrhosis. For example, in the case of alcoholic cirrhosis, active efforts to abstain from alcohol and rehabilitative treatment are necessary. If the cirrhosis is caused by chronic hepatitis B virus infection, antiviral treatment should be administered.

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Written by Shen Jiang Chao
Radiology
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Can cirrhosis be detected by a CT scan?

Cirrhosis can be detected by a CT scan. Early-stage cirrhosis has no specific diagnostic value on CT, but middle to late-stage cirrhosis typically manifests as wavy changes in the liver capsule, enlarged liver lobes, and disproportionate size of liver lobes, with most changes involving an enlargement of the left lobe and caudate lobe and a relative shrinkage of the right lobe. Additionally, secondary manifestations of cirrhosis, such as portal hypertension, can cause enlargement of the spleen and varices in the lower esophagus and stomach fundus. When cirrhosis is detected, it is advisable to perform an enhanced CT scan to determine the potential for malignant transformation in liver regenerative nodules.

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Is stool black in the early stages of cirrhosis?

In the early stages of cirrhosis, it is generally not common to see black stools. Patients in the early stages of cirrhosis may not experience complications associated with the condition, such as portal hypertensive gastropathy and esophagogastric varices, nor would they likely suffer from peptic ulcers, etc. However, if patients with cirrhosis do not actively seek treatment or undergo regular check-ups, they could develop conditions like peptic ulcers and possibly esophagogastric varices that may rupture and bleed, leading to black stools. If black stools occur, it is important to promptly complete an endoscopic examination to confirm the diagnosis. Under endoscopy, hemostatic treatment should be performed. It is also crucial to actively rehydrate, suppress gastric acid secretion, and protect the gastric mucosa among other treatments.

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What is the cause of a gurgling stomach in cirrhosis?

Cirrhosis patients experiencing gurgling noises in the abdomen may suffer from functional dyspepsia due to cirrhosis, leading to accelerated intestinal motility and the mentioned symptoms. It is also possible that patients with cirrhosis may concurrently have acute enteritis, causing these symptoms. If these symptoms occur, further comprehensive stool tests are necessary to determine whether the symptoms are caused by a viral or bacterial infection. Depending on the cause, different treatment measures should be adopted. Consider using montmorillonite powder to stop diarrhea and using Bacillus cereus, composite lactic acid bacteria, etc., to regulate the intestinal flora. Given the patient's cirrhosis, proactive liver treatment is essential. (Please use medications under the guidance of a doctor.)