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    Hepato Splenomegaly

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    loyea
    This patient presents with hepatosplenomegaly without evidence of cirrhosis. On examination, the liver and spleen are both enlarged. The differential diagnoses include chronic infections, hematological disorders, malignancies, and infiltrative diseases. Further examination and testing is needed to determine the predominantly enlarged organ and identify any signs of liver disease, in order to diagnose the underlying cause and guide management.

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    Hepato Splenomegaly

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    loyea
    85 views3 pages
    This patient presents with hepatosplenomegaly without evidence of cirrhosis. On examination, the liver and spleen are both enlarged. The differential diagnoses include chronic infections, hematological disorders, malignancies, and infiltrative diseases. Further examination and testing is needed to determine the predominantly enlarged organ and identify any signs of liver disease, in order to diagnose the underlying cause and guide management.

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    Hepato splenomegaly

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    This patient presents with hepatosplenomegaly without evidence of cirrhosis. On examination, the liver and spleen are both enlarged. The differential diagnoses include chronic infections, hematological disorders, malignancies, and infiltrative diseases. Further examination and testing is needed to determine the predominantly enlarged organ and identify any signs of liver disease, in order to diagnose the underlying cause and guide management.

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    85 views3 pages

    Hepato Splenomegaly

    Uploaded by

    loyea
    This patient presents with hepatosplenomegaly without evidence of cirrhosis. On examination, the liver and spleen are both enlarged. The differential diagnoses include chronic infections, hematological disorders, malignancies, and infiltrative diseases. Further examination and testing is needed to determine the predominantly enlarged organ and identify any signs of liver disease, in order to diagnose the underlying cause and guide management.

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    Hepatosplenomegaly

    Presentation
    Sir this patient has hepatosplenomegaly without evidence of cirrhosis of the liver.
    (I say this because enlarged masses in the right and left hypochondrial regions of
    which I am unable to get above theses masses and is not bimanually palpable or
    ballotable. Hence, these are unlikely to be due to kidney masses.)
    The liver is enlarged
    Sie, edge, surface, consistency, tender, bruit or pulsatile
    The spleen is enlarged
    Sie, edge, surface, consistency, tender
    !idneys are not enlarged and no associated ascites
    "eripheral e#amination
    $%& stigmata, 'aundice, bruises
    Hepatic encephalopathy
    $auses
    o "allor, cache#ia, $# %(s, ")*
    o To#ic, rashes, tonsils
    o $hronic ethanol ingestion
    o $$+
    o S,-, S%-, )., Hemolytic anaemia
    I would like to complete the e#amination
    In summary, this patient has hepatosplenomegaly that is associated with. The
    differential diagnoses are/
    (&etermine which is the predominantly enlarged organ eg massive liver with small
    spleen or massively spleen with small liver0 determine if there is any $s liver findings
    such as pulsatile liver0 if both are mildy enlarged then combine the causes)

    Massive Splenomegaly (>8 cm)
    $1%
    1yelofibrosis
    ")*
    $hronic malaria
    !ala2aar (visceral leshmaniasis)
    3thers(4aucher5s, rapidly progressive lymphoma)
    Moderately Enlarged (4 to 8 cm/ 2-4 FB)
    1yeloproliferative
    %ymphoproliferative
    Haemotological 6 .I, IT", Thalassemia and HS
    $hronic malaria
    $irrhosis
    Mildly Enlarged(4cm</-2FB)
    1yeloproliferative, %ymphoproliferative
    Infections
    *iral 6 $1*,-,*
    S,-, splenic abscesses, leptospirosis, 1eliodosis, T,, Typhoid,
    ,rucellosis(farmer)
    .cute malaria
    Infiltrative 6 .mylodosis, Sacoidosis
    -ndocrine 6 .cromegaly, thyroto#icosis
    $ollagen vascular 6 S%-, +elty5s
    $hronic haemolytic 6 Thalassemia, .I, HS, IT"
    !ender spleen
    Infective causes
    .cute myeloproliferative and lymphoproliferative
    "allor(same as moderately enlarged spleen)
    1yeloproliferative
    %ymphoproliferative
    1alaria
    Hemolytic anaemia(Thal and .IH.)
    .I 6 +elty5s, S%-
    $irrhosis of the liver with portal hypertension
    #ymp$ %odes
    %ymphoproliferative($%%7lymphoma)
    Infective(I1S, 1eliodosis, $1*, T,, HI*)
    Massive #iver
    H$$7Secondaries7myeloprolif
    )*+
    .lcoholic liver disease
    Mild-moderate #iver
    .s above plus
    Infection
    *iruses 6 -,*, $1*, hepatitis . 8 ,
    ,acteria 6 9eil5s disease (leptospirosis), meliodosis, abscesses, T,,
    brucellosis, syphilitic gumma
    "rotooal 6 hydatid cysts, amoebic abscess
    1alignancy 6 lymphoproliferative, myeloproliferative, primary, secondary,
    adenoma from 3$"
    Infiltrative 6 sarcoid (erythema nodosum, lupus pernio), amyloid, fatty liver
    -ndocrine 6 acromegaly, hyperthyroid
    $ollagen *ascular disease
    $hronic hemolytic anaemia( .I, thalassemia, HS)
    )eidel5s lobe
    "ossibility of minimal $%& signs with 'ust hepatomegaly
    ",$
    Hemochromatosis
    !ender #iver
    %iver abscess7infective (viral7bacterial7parasitic)
    H$$7Secondaries
    )ight Heart +ailure7,udd chiari
    "&lsatile #iver
    T)
    H$$
    .*1
    'ard/(rreg&lar #iver
    1itotic (primary7Secondary)
    1acronodular cirrhosis (post hepatitis ,7$, 9ilson5s and ..T)
    .myloidosis7Hydatid cyst7granulomatous disease7gummatous disease7."$!&
    Questions
    9hat are the causes:
    How would you investigate:
    How would you manage:
    (See notes on individual causes in Splenomegaly and Hepatomegaly)

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