Die Milz bei Lebererkrankungen

Summary

In patients with diseases of the liver portal hypertension and cellular proliferation produce reactive changes in the spleen. The size of the spleen and its function as a filter were determined quantitatively with isotope-labeled, heat-induced spherocytes. In 96% of the investigated liver diseases (acute and chronic hepatitis, cirrhosis and steatosis of the liver) either the size or the filter function of the organ are altered, frequently both of them.

2. The so-called hypersplenic syndrome cannot be correlated with the size of the spleen in chronic hepatitis and liver cirrhosis. The filter function for heat-damaged erythrocytes is at least relatively diminished in so-called hypersplenic spleens. Considering the pathogenesis of the acquired hemocytopenias it appears that the environmentally and metabolically induced damage of the blood cells have greater significance than a pathologically enhanced sequestration function of the spleen.

3. The special position of the spleen in the immunopathogenesis of chronic aggressive hepatitis has a theoretical basis. In fact, chronic aggressive hepatitis can be improved by splenectomy with only little operative risks. Early operation should be aimed for. The question whether or not splenectomy under these circumstances results in a surgically accomplished immunosuppression has to remain open.