Abdomen short cases
You found a massive hepatosplenomagaly
(firm spleen). What this could be due to?
Transfusion dependant anemia
e.g. β thalessmia major
Gaucher’s Dx, osteopetrosis, pure red cell
Why β thalessmia major?
Because it is common
Do you think this child is adequately
Inadequate transfusion result in
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. Cardiac: auscultate chest for
3. Endocrinei. Gonads - Tanner
ii. Thyroid- T4
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
FBC→ abnormal cells
Needs BM biopsy to exclude