The term “hepatosplenic” refers to conditions involving both the liver and spleen. Though distinct, these organs are often discussed together due to close physiological connections and how diseases affect them simultaneously. Their combined involvement often signals a systemic health issue.
The Liver and Spleen: Basic Roles
The liver, in the upper right abdomen, filters blood toxins, processes nutrients, and produces bile. It converts food into energy, stores vitamins and minerals, and synthesizes proteins for clotting and immunity.
The spleen, in the upper left abdomen, filters blood, removing old or damaged red blood cells and recycling components. It aids the immune system by producing white blood cells and antibodies. It serves as a reservoir for immune cells and stores blood.
Why They Are Often Linked
The liver and spleen are often linked by shared circulatory pathways, especially the portal venous system. Blood from digestive organs flows through the portal vein into the liver. The spleen also drains into this system via the splenic vein. This connection means conditions affecting portal system blood flow or pressure, such as portal hypertension, can impact both.
Beyond circulatory ties, both organs are major components of the reticuloendothelial system, involved in immunity and cellular debris removal. They contain specialized immune cells, like macrophages, that filter blood and respond to pathogens. Systemic infections, inflammatory conditions, or blood disorders can trigger a simultaneous response.
Conditions Affecting Both Organs
Many conditions involve both the liver and spleen, often leading to enlargement (hepatosplenomegaly).
Infections
Infections are common. Viral infections like mononucleosis often swell both organs. Parasitic infections such as malaria and leishmaniasis cause enlargement from chronic inflammation. Chronic viral hepatitis (B and C) leads to liver damage and cirrhosis, causing portal hypertension and spleen enlargement.
Blood Disorders
Blood disorders are another category. Hemolytic anemias, where red blood cells are prematurely destroyed, often enlarge the spleen as it filters damaged cells. The liver may be affected by increased bilirubin processing. Myeloproliferative disorders, bone marrow cancers producing too many blood cells, enlarge both organs as they become sites of abnormal blood cell production.
Metabolic Disorders
Metabolic disorders involve abnormal substance accumulation in cells, including the liver and spleen. Gaucher disease, a genetic disorder, causes fatty substances to build up, leading to hepatosplenomegaly, bone problems, and neurological issues. Niemann-Pick disease causes lipids to accumulate in the liver and spleen, impairing function.
Cancers
Cancers affect both organs. Lymphomas, cancers of the lymphatic system, frequently involve the spleen and spread to the liver. Leukemias, cancers of blood-forming tissues, infiltrate both organs, causing enlargement from abnormal white blood cell proliferation. Metastatic cancers, which spread from a primary tumor, commonly affect the liver due to its blood-filtering role.
Congestive Conditions
Congestive conditions, affecting blood flow, link the two organs. Portal hypertension, increased blood pressure within the portal venous system, frequently causes spleen enlargement as blood backs up into the splenic vein. This elevated pressure can lead to liver dysfunction and fluid accumulation. Severe heart failure causes blood to back up into the liver and, less commonly, the spleen, leading to enlargement.
What to Look For and Next Steps
Symptoms of liver or spleen issues are varied and non-specific. General signs include persistent fatigue, unexplained weight loss, and a general feeling of being unwell. Abdominal discomfort or pain, especially in the upper right or left side, signals organ enlargement.
Specific signs:
- Jaundice (yellowing of skin and eyes)
- Easy bruising or bleeding
- Feeling of fullness after small meals
- Pain radiating to the left shoulder
- Fever and chills
Prompt medical attention is advised for these symptoms. A provider will begin with:
- A physical examination, checking for abdominal tenderness or enlargement.
- Blood tests to assess liver function, blood cell counts, and infection or inflammation markers.
- Imaging studies (ultrasound, CT scans, MRI) for detailed images of the liver and spleen, determining size, structure, and abnormalities.
- Further specialized tests, depending on initial findings, to identify the cause.
Citations
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Liver: Anatomy and Functions”, content: “The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown and feels rubbery to the touch. Normally, you can’t feel the liver. It’s tucked away safely under the rib cage.\n\nThe liver has many functions. It processes what you eat and drink into energy and nutrients, and it removes harmful substances from your blood. Your liver also makes bile, a fluid that helps digest fats. Bile is stored in the gallbladder until it’s needed.\n\nSome of the liver’s other functions include:\n\n Making proteins that help blood clot\n Storing vitamins and minerals\n Helping to regulate blood sugar levels\n Making cholesterol and other fats\n Converting ammonia to urea, which is then excreted in urine”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Spleen: Anatomy, Function, and Conditions”, content: “The spleen is an organ located in the upper left part of your abdomen, just under your rib cage. It’s part of your lymphatic system, which is part of your immune system. The spleen has several important jobs, including:\n\n Filtering blood: The spleen filters old, damaged, or abnormal red blood cells from your blood. It also removes bacteria and other foreign particles.\n Producing white blood cells: The spleen produces lymphocytes, a type of white blood cell that helps fight infection.\n Storing blood: The spleen can store a small amount of blood, which it can release into your bloodstream if you need it.\n Making antibodies: The spleen produces antibodies, which are proteins that help your body fight infection.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Portal Vein: Anatomy, Function, and Conditions”, content: “The portal vein is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas, and spleen to the liver. This blood is rich in nutrients and toxins that have been absorbed from the digestive system. The liver processes these substances before they enter the general circulation.\n\nThe portal vein is formed by the union of the superior mesenteric vein and the splenic vein. The inferior mesenteric vein usually drains into the splenic vein.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Reticuloendothelial System: Function and Disorders”, content: “The reticuloendothelial system (RES) is a network of cells and tissues found throughout the body, including the liver, spleen, lymph nodes, and bone marrow. It plays a crucial role in immunity, inflammation, and the removal of cellular debris and foreign particles.\n\nThe RES is composed of phagocytic cells, such as macrophages, which engulf and digest foreign substances. These cells are particularly abundant in the liver (Kupffer cells) and spleen (splenic macrophages), where they filter blood and remove old or damaged red blood cells, bacteria, and other pathogens.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Mononucleosis”, content: “Mononucleosis, often called ‘mono’ or ‘the kissing disease,’ is an infectious disease caused by the Epstein-Barr virus (EBV). It commonly affects teenagers and young adults. Symptoms include fatigue, fever, sore throat, and swollen lymph nodes. In some cases, the spleen may become enlarged (splenomegaly) and, less commonly, the liver may also be affected (hepatomegaly).”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Malaria: Symptoms, Causes, and Treatment”, content: “Malaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. Left untreated, they may develop severe complications and die. In severe cases, malaria can cause enlargement of the spleen (splenomegaly) and liver (hepatomegaly).”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Leishmaniasis: Symptoms, Causes, and Treatment”, content: “Leishmaniasis is a disease caused by parasites of the genus Leishmania. These parasites are transmitted to humans through the bite of infected sandflies. There are several forms of leishmaniasis, including visceral leishmaniasis (VL), also known as kala-azar, which is the most severe form. VL is characterized by fever, weight loss, enlargement of the spleen (splenomegaly), and enlargement of the liver (hepatomegaly).”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Hepatitis B and C: Causes, Symptoms, and Treatment”, content: “Hepatitis B and C are viral infections that cause inflammation of the liver. Chronic infection with these viruses can lead to serious complications, including cirrhosis (scarring of the liver), liver cancer, and liver failure. Cirrhosis can cause portal hypertension, which is increased pressure in the portal vein, leading to an enlarged spleen (splenomegaly).”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Hemolytic Anemia: Causes, Symptoms, and Treatment”, content: “Hemolytic anemia is a condition in which red blood cells are destroyed faster than they can be made. The spleen plays a role in removing old or damaged red blood cells, so in hemolytic anemia, the spleen may become enlarged (splenomegaly) as it works harder. The liver may also be affected due to the increased workload of processing bilirubin, a byproduct of red blood cell breakdown.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Myeloproliferative Neoplasms: Types, Symptoms, and Treatment”, content: “Myeloproliferative neoplasms (MPNs) are a group of blood cancers that occur when the bone marrow produces too many red blood cells, white blood cells, or platelets. These include chronic myeloid leukemia (CML), polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). MPNs often lead to an enlarged spleen (splenomegaly) and sometimes an enlarged liver (hepatomegaly) as these organs may become involved in blood cell production outside the bone marrow.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Gaucher Disease: Symptoms, Causes, and Treatment”, content: “Gaucher disease is a rare, inherited metabolic disorder in which a fatty substance called glucocerebroside builds up in cells and certain organs. The most common signs and symptoms include an enlarged spleen (splenomegaly) and liver (hepatomegaly), bone pain and fractures, and anemia. The severity of symptoms can vary widely among individuals.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Niemann-Pick Disease: Types, Symptoms, and Treatment”, content: “Niemann-Pick disease is a group of rare, inherited metabolic disorders that affect the body’s ability to metabolize fats (lipids), cholesterol, and other substances within cells. These substances accumulate in various organs, including the spleen, liver, lungs, bone marrow, and brain. Enlargement of the spleen (splenomegaly) and liver (hepatomegaly) is a common feature, especially in types A and B.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Lymphoma: Types, Symptoms, and Treatment”, content: “Lymphoma is a cancer of the lymphatic system, which is part of the body’s germ-fighting network. The lymphatic system includes the lymph nodes, spleen, thymus gland, and bone marrow. Lymphoma can begin in any of these areas, including the spleen, and can spread to other organs like the liver, causing enlargement of both organs.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Leukemia: Types, Symptoms, and Treatment”, content: “Leukemia is a cancer of the body’s blood-forming tissues, including the bone marrow and the lymphatic system. It usually involves the white blood cells. There are several types of leukemia, including acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), and chronic lymphocytic leukemia (CLL). In many types of leukemia, abnormal white blood cells can accumulate in the spleen and liver, leading to their enlargement (splenomegaly and hepatomegaly).”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Metastatic Cancer: Understanding Spread and Treatment”, content: “Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. The liver is a common site for metastasis because of its rich blood supply and its role in filtering blood from the digestive system. While less common, metastatic cancer can also spread to the spleen.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Portal Hypertension: Causes, Symptoms, and Treatment”, content: “Portal hypertension is an increase in the blood pressure within the portal venous system, which carries blood from the digestive organs to the liver. It is most often caused by cirrhosis, a condition in which scar tissue replaces healthy liver tissue. The increased pressure can cause blood to back up into the spleen, leading to an enlarged spleen (splenomegaly). It can also lead to fluid accumulation in the abdomen (ascites) and bleeding from enlarged veins in the esophagus (esophageal varices).”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Heart Failure: Causes, Symptoms, and Treatment”, content: “Heart failure, sometimes known as congestive heart failure, is a condition in which the heart muscle doesn’t pump blood as well as it should. When the heart can’t pump effectively, blood can back up in the veins that carry blood away from the organs. This can lead to fluid buildup in various parts of the body. In severe cases, blood can back up into the liver, causing it to become enlarged (hepatomegaly) and tender. Less commonly, the spleen may also become congested and enlarged.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Hepatosplenomegaly: Symptoms, Causes, and Diagnosis”, content: “Hepatosplenomegaly is a condition in which both the liver (hepato-) and the spleen (spleno-) are enlarged (-megaly). Symptoms can vary depending on the underlying cause but often include abdominal discomfort or pain, fatigue, weight loss, and a general feeling of being unwell. The enlarged organs may be felt during a physical examination.”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Liver Disease: Symptoms, Causes, and Treatment”, content: “Symptoms of liver disease can include:\n\n Jaundice (yellowing of the skin and eyes)\n Dark urine\n Pale stools\n Swelling in the legs and ankles\n Easy bruising or bleeding\n Chronic fatigue\n Nausea or vomiting\n Abdominal pain or swelling”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Enlarged Spleen (Splenomegaly): Symptoms, Causes, and Treatment”, content: “An enlarged spleen (splenomegaly) may not cause any symptoms, or it may cause:\n\n A feeling of fullness after eating only a small amount, due to the enlarged spleen pressing on the stomach\n Pain or discomfort in the upper left abdomen, which may spread to the left shoulder\n Fatigue\n Frequent infections\n Easy bleeding”
url: “https://vertexaisearch.googleapis.com/v1/projects/103233810061/locations/global/collections/default_collection/dataStores/default_data_store/servingConfigs/default_serving_config:search”, title: “Diagnosis of Hepatosplenomegaly”, content: “The diagnosis of hepatosplenomegaly typically involves a physical examination, blood tests, and imaging studies. During a physical exam, your doctor may feel your abdomen to check for enlarged organs. Blood tests can help assess liver function, blood cell counts, and identify markers of infection or inflammation. Imaging studies, such as ultrasound, CT scans, or MRI, can provide detailed images of the liver and spleen and help determine the underlying cause.”