Short cases in Abdomen: in paediatrics-final MBBS

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This is not a complete note or a guide. This was prepared by me based on the teachings of Dr.R.M.Mudiyanse just to aid the short cases.

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Short cases in Abdomen: in paediatrics-final MBBS

  1. 1. Abdomen short cases Possible cases Hepatosplenomegaly Ascites Renal lump You found a massive hepatosplenomagaly (firm spleen). What this could be due to? Transfusion dependant anemia e.g. β thalessmia major aplastic anemia Gaucher’s Dx, osteopetrosis, pure red cell aplasia, HS Why β thalessmia major? Because it is common Do you think this child is adequately transfused? Inadequate transfusion result in Growth failure Bony deformities Splenomegaly or early splenectomy Pallor is indicative of this episode But still need to know pre-transfusion Hb level 9.5-10g/dl Inadequate chelation results in 1. Pigmentation 2. Complications 1. Cardiac: auscultate chest for murmurs 2. Hepatic 3. Endocrinei. Gonads - Tanner stage ii. Thyroid- T4 iii. DM But still need to know trend of serum ferritin level: 100-200 normal 1000-1500 adequate Adherent to chelation regime Why do you say this is spleen? 1. Has its shape & notch 2. Can not feel the upper border 3. Not ballotable 4. No band of resonance 5. Direction of enlargement towards RIF Could this be leukemia? 1. Ill looking 2. Bone tenderness 3. 4. 5. 6. 7. Pallor LNE Splenomegaly FBC→ abnormal cells Needs BM biopsy to exclude

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