Portal Hypertension Splenomegaly

Why the spleen becomes enlarged

When blood cannot easily flow through the liver, it tries to bypass the portal system, using the systemic venous system to return to the heart. Symptoms of portal hypertension are caused by the complications of decreased blood flow through the liver and increased pressure within veins where blood is shunted.

Splenomegaly, one of the symptoms of portal hypertension, is an enlargement of the spleen caused by a decrease in blood flow through the splenic vein. The decreased ability of blood to drain from the spleen causes it to become congested and grow larger.

Although an enlarged spleen may cause no symptoms or signs, they can include:

  • Indigestion and a feeling of fullness when the enlarged spleen compresses the stomach,
  • Hiccups because of diaphragm irritation, and
  • Pain in the upper abdomen that may radiate to the back or shoulder blade.