Hepatosplenomegaly

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Asalam o Alekum This is by Doctor Taimoor Kayani to help Medical Students in there Educational Life :)

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Differential diagnosis of hepatosplenomegaly:

Differential diagnosis of hepatosplenomegaly By Muhammad Taimoor

Definition:

Morphological changes in hepatolienal syndrome characterized mainly by hyperplasia of the reticulo-histocytes liver and spleen, fibroplastic reaction, in some cases, infiltrative-proliferative and degenerative diseases of blood vessels processes. Definition

Diagnosis of hepatosplenomegaly itself usually presents no difficulties, and is made by palpation and percussion. :

Diagnosis of hepatosplenomegaly itself usually presents no difficulties, and is made by palpation and percussion .

Feature of Hepatolienal syndrome are emerging signs of hypersplenism - leukopenia, and thrombocytopenia erythrocytopenia, which appear in the usual clinical analysis of blood. :

Feature of Hepatolienal syndrome are emerging signs of hypersplenism - leukopenia, and thrombocytopenia erythrocytopenia, which appear in the usual clinical analysis of blood.

Diagnostic algorithm is based on a thorough observation of data from medical history and patient complaints and physical examination. Necessary to specify the age at which there were first signs of the disease (hepatosplenomegaly in children is more common than in adults, since early communication elements of a single mononuclear phagocytic system is much stronger), the presence of similar symptoms in other family members should also be checked.:

Diagnostic algorithm is based on a thorough observation of data from medical history and patient complaints and physical examination. Necessary to specify the age at which there were first signs of the disease (hepatosplenomegaly in children is more common than in adults, since early communication elements of a single mononuclear phagocytic system is much stronger), the presence of similar symptoms in other family members should also be checked.

In chronic liver diseases and portal system in addition to hepatosplenomegaly, there is usually pain and / or heaviness in the right upper quadrant, the complaints on various dyspeptic disorders, pruritus, and jaundice.:

In chronic liver diseases and portal system in addition to hepatosplenomegaly, there is usually pain and / or heaviness in the right upper quadrant, the complaints on various dyspeptic disorders, pruritus, and jaundice.

In the history of the patients we should look for guidance on deferred viral hepatitis, contact with infectious patients, trauma or surgery of the liver, chronic alcoholism, the uptake of potentially hepatotoxic drugs, and also acute attacks of abdominal pain (splenic vein thrombosis), and fever.:

In the history of the patients we should look for guidance on deferred viral hepatitis, contact with infectious patients, trauma or surgery of the liver, chronic alcoholism, the uptake of potentially hepatotoxic drugs, and also acute attacks of abdominal pain (splenic vein thrombosis), and fever.

Chronic liver diseases are accompanied by the presence of extrahepatic signs - skin telangiectasias, gynecomastia, "liver" , palms, fingers and nail changes ("drumsticks" and "hour glass"), hair loss.:

Chronic liver diseases are accompanied by the presence of extrahepatic signs - skin telangiectasias , gynecomastia , "liver" , palms , fingers and nail changes ("drumsticks" and "hour glass"), hair loss.

Usually there are signs of portal hypertension, and their early appearance is characteristic lesion of portal and splenic veins. Thrombophlebitis, thrombosis and splenic vein, and stenosis of the portal or splenic veins lead to the domination of splenomegaly hepatomegaly and jaundice and signs of liver functional state are not detected. In some cases, may experience pain in the left upper quadrant and hyperthermia:

Usually there are signs of portal hypertension, and their early appearance is characteristic lesion of portal and splenic veins. Thrombophlebitis, thrombosis and splenic vein, and stenosis of the portal or splenic veins lead to the domination of splenomegaly hepatomegaly and jaundice and signs of liver functional state are not detected. In some cases, may experience pain in the left upper quadrant and hyperthermia

Storage diseases are common among family members or close relatives. It effects mainly men. In addition to Hepatolienal syndrome, there is hyperpigmentation of the skin and mucous membranes may be signs of liver cirrhosis, hypogonadism, and diabetes.:

Storage diseases are common among family members or close relatives. It effects mainly men. In addition to Hepatolienal syndrome , there is hyperpigmentation of the skin and mucous membranes may be signs of liver cirrhosis, hypogonadism, and diabetes.

Extrahepatic signs do not occur as frequently as in chronic liver diseases. Portal hypertension and hepatic failure occur late and appear in the terminal phase of illness.:

Extrahepatic signs do not occur as frequently as in chronic liver diseases. Portal hypertension and hepatic failure occur late and appear in the terminal phase of illness.

Hepatolenticular degeneration (Wilson's disease) due to impaired binding of copper. This is a hereditary pathology, transmitted in an autosomal recessive manner. Symptoms usually appear between the ages of 5 to 30 years. Liver damage may occur as acute hepatitis, chronic active hepatitis or cirrhosis. Later joined by symptoms of central nervous system (motor disorders associated with degeneration of the basal ganglia, as well as a variety of mental disabilities). The cornea in patients usually have a ring Kayser-Fleyshnera greenish-brown color. :

Hepatolenticular degeneration (Wilson's disease) due to impaired binding of copper. This is a hereditary pathology, transmitted in an autosomal recessive manner. Symptoms usually appear between the ages of 5 to 30 years. Liver damage may occur as acute hepatitis, chronic active hepatitis or cirrhosis. Later joined by symptoms of central nervous system (motor disorders associated with degeneration of the basal ganglia, as well as a variety of mental disabilities). The cornea in patients usually have a ring Kayser-Fleyshnera greenish-brown color.

Haucher disease is manifested continually increasing hepatosplenomegaly, marked bone pain, osteolysis, retarded physical and mental development, is expressed hypersplenism and hypochromic anemia.:

Haucher disease is manifested continually increasing hepatosplenomegaly, marked bone pain, osteolysis, retarded physical and mental development, is expressed hypersplenism and hypochromic anemia.

Amyloidosis may be associated not only with Hepatolienal syndrome, but also, more rarely, with the advent of cholestatic jaundice and pruritus,. In most cases, the skin in patients is pale, dry, with a "marbled" pattern can be observed, macroglossia.:

Amyloidosis may be associated not only with Hepatolienal syndrome, but also, more rarely, with the advent of cholestatic jaundice and pruritus ,. In most cases, the skin in patients is pale, dry, with a "marbled" pattern can be observed, macroglossia.

infectious and parasitic Diseases, usually do not cause difficulty in diagnosis, as they are accompanied by characteristic history, marked symptoms of intoxication, fever, arthralgia or myalgia.:

infectious and parasitic Diseases, usually do not cause difficulty in diagnosis, as they are accompanied by characteristic history, marked symptoms of intoxication, fever, arthralgia or myalgia.

Diseases of the hematopoietic system, accompanied by the development of Hepatolienal syndrome Are usually characterized by the specific appearance of the patients (minor icteric against pallor, marked hemorrhagic syndrome), a significant weakness, fever, wrong type of enlarged lymph nodes.:

Diseases of the hematopoietic system, accompanied by the development of Hepatolienal syndrome Are usually characterized by the specific appearance of the patients (minor icteric against pallor, marked hemorrhagic syndrome), a significant weakness, fever, wrong type of enlarged lymph nodes.

Acute leukemia causes slight enlargement of the spleen, whereas in chronic myeloid leukemia, it can reach gigantic proportions, and preceded by hepatomegaly. In contrast, chronic lymphocytic leukemia is primarily an increase in the liver and then only the spleen.:

Acute leukemia causes slight enlargement of the spleen, whereas in chronic myeloid leukemia, it can reach gigantic proportions, and preceded by hepatomegaly. In contrast, chronic lymphocytic leukemia is primarily an increase in the liver and then only the spleen.

Chronic cardiovascular disease with the development of heart failure have their specific symptoms, which occurs before the development of hepatosplenomegaly, and therefore difficulty in diagnosis, as a rule, does not arise.:

Chronic cardiovascular disease with the development of heart failure have their specific symptoms, which occurs before the development of hepatosplenomegaly, and therefore difficulty in diagnosis, as a rule, does not arise.

laboratory diagnosis has a great Importance for diagnosis. Various tests can be done to determining the functional state of liver, Like the level of serum iron and Serum Plasma and other indicators.:

laboratory diagnosis has a great Importance for diagnosis. Various tests can be done to determining the functional state of liver , Like the level of serum iron and Serum Plasma and other indicators.

Instrumental investigations begin with ultrasound , computed tomography and angiography have large diagnostic capabilities , allowing to specify the true size of the spleen and liver , blood flow obstructions in the portal vein, diffuse or focal nature of the lesion:

Instrumental investigations begin with ultrasound , computed tomography and angiography have large diagnostic capabilities , allowing to specify the true size of the spleen and liver , blood flow obstructions in the portal vein, diffuse or focal nature of the lesion

In the diagnosis of diseases of accumulation greater role for percutaneous biopsy of the liver and spleen, and hematopoietic system diseases diagnosed by needle biopsy of bone marrow and lymph nodes.:

In the diagnosis of diseases of accumulation greater role for percutaneous biopsy of the liver and spleen, and hematopoietic system diseases diagnosed by needle biopsy of bone marrow and lymph nodes.

Thanks for your Attention :

Thanks for your Attention 

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