Hepatosplenomegaly

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 • Size, edge, surface, consistency, tender, bruit or pulsatile The spleen is enlarged • Size, edge, surface, consistency, tender Kidneys are not enlarged and no associated ascites Peripheral examination • CLD stigmata, jaundice, bruises • Hepatic encephalopathy • Causes o Pallor, cachexia, Cx LNs, PRV o Toxic, rashes, tonsils o Chronic ethanol ingestion o CCF o SBE, SLE, RA, Hemolytic anaemia I would like to complete the examination In summary, this patient has hepatosplenomegaly that is associated with. The differential diagnoses are: (Determine which is the predominantly enlarged organ eg massive liver with small spleen or massively spleen with small liver; determine if there is any Cs liver findings such as pulsatile liver; if both are mildy enlarged then combine the causes) Massive Splenomegaly (>8 cm) • CML • Myelofibrosis • PRV • Chronic malaria • Kala-azar (visceral leshmaniasis) • Others(Gaucher’s, rapidly progressive lymphoma) Moderately Enlarged (4 to 8 cm/ 2-4 FB) • Myeloproliferative • Lymphoproliferative • Haemotological – AI, ITP, Thalassemia and HS • Chronic malaria • Cirrhosis

Mildly Enlarged(4cm