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.

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