Moderate Splenomegaly (3 to 5 Fingers)

CLINICAL DIAGNOSTIC MANUAL

Moderate splenomegaly refers to an enlargement of the spleen palpable between 3 to 5 fingers below the left costal margin. This degree of splenic enlargement can be a sign of various haematological, hepatic, and systemic pathologies.

Moderate splenomegaly typically indicates a more advanced or chronic condition compared to mild splenomegaly, and requires careful clinical evaluation to identify the underlying cause and establish an appropriate treatment plan.

Condition	Symptoms and Clinical Signs	Suspicion Diagnosis	Confirmatory Diagnosis
Lymphoma	Fatigue, fever, night sweats, weight loss, lymphadenopathy, splenomegaly, hepatomegaly, possible abdominal pain	Clinical history, clinical symptoms	Lymph node biopsy, abdominal CT/MRI, haematological tests
Chronic Leukaemia	Fatigue, weight loss, night sweats, fever, anaemia, lymphadenopathy, splenomegaly, recurrent infections	Clinical history, clinical symptoms	Complete blood count, bone marrow aspiration/biopsy
Cirrhosis with or without Portal Hypertension	Jaundice, fatigue, ascites, oesophageal varices, hepatic encephalopathy, splenomegaly, haematemesis, palmar erythema, spider angiomas	Clinical history, clinical symptoms	Liver function tests, abdominal ultrasound, upper gastrointestinal endoscopy