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FAHAD AL ZAMIL Professor & Consultant Paediatric Infectious Diseases King Khalid University Hospital King Saud University, Riyadh
Mean liver span: In the Newborn: 4.5 – 5 cm 12 years: boys: 7 – 8 cm 12 years: girls: 6 – 6.5 cm Extends from 5 th intercostal space in the midclavicular line 5 – 8 cm
Lower edge not more than 2 cm below the costal margin in infancy (1 cm in childhood) A normal-size liver may be displaced downward (e.g. pulmonary hyperinflation)
Tip of spleen is normally palpable in 1/3 of full-term infants May be felt up to 5 years of age. After that a palpable spleen is presumed to be enlarged
Fever, jaundice, pallor, bleeding, tea-colored urine, bone & joint pains, weight loss, abnormal sweating, anorexia, abdominal distention, pain, trauma, food or drug exposure Exposure to infections (hepatitis, mononucleosis, TB, amebiasis) Hematological disease (SCA, Thalassemia), cardiac disease, collagen vascular disorder, storage diseases
Measure liver span Determine liver’s contour & consistency Is the surface smooth, irregular or nodular? Is the edge rounded or sharp? Is palpation painful? DO NO HARM! Listen for bruit
Any ascites ? Increased portal venous pressure, tissue infiltration, or reticuloendothelial cell hyperplasia In newborns: do fundoscopy for chorioretinitis Congenital infections Note: skin lesions, subcutaneous nodules, lymphadenopathy, spider angiomata or stigmata of storage disease
Infective: Viral: Hepatotrophic (A,B,C,D,E) Other viruses (herpes, cytomegalo, Ebstein-Barr, varicella, HIV, rubella, adenovirus, enterovirus, arbovirus)
Infective: Protozoal: malaria, kalazar, amoebic, toxoplasma Bacterial: sepsis; tuberculosis, brucellosis, syphilis Helminths: hydatid, visceral larva migrans Fungal: histoplasmosis
Hematological: Haemolytic: haemolytic disease of newborn, thalassaemia Metabolic: Nieman-Pick, Gaucher, gangliosidosis, mucopolysaccharidosis, glycogen storage
Malignancies: Leukemia, histiocytic syndromes, myeloproliferative syndromes, lymphomas Immunological: Chronic granulomatous disease, hereditary neutrophilia, Ommen syndrome.
Developmental: Congenital hepatic fibrosis Congestive: Hepatic vein obstruction, constrictive pericarditis
According to the case, may include: CBC, retics Blood film Malaria smear LFT, PT, Ammonia Hepatitis tests Monospot test PPD
TORCH α-fetoprotein Bone Marrow Aspiration Urinalysis Ultrasound CT scan Angiography Needle aspiration
Approach To A Child With Hepatosplenomegaly Dr. Pushpa Raj Sharma Professor of Child Health Institute of Medicine.
HEPATOSPLENOMEGALY PBL 22 SUPERVISED BY: DR. WALAA SHABANA.
Paediatric liver conditions Present with combinations of the following symptoms and signs Jaundice Encephalopathy (altered consciousness or behaviour)
Lymphadenopathy in Children FAHAD AL ZAMIL Professor & Consultant Paediatric Infectious Diseases King Khalid University Hospital.
Lymphoid malignancies. Lymphoproliferative disorders Etiology: Overstimulation Defect of regulation (X-linked lymphoproliferative syndrome) Defects of.
Normal spleen. Ectopic position of the spleen:- Left flank Pelvis Posterior to the left kidney.
APPROACH TO PATIENT WITH SPLENOMEGALY Thamer A. AL-TRAIKI
SPLENOMEGALY and LYMPHADENOPATHIES Hasan Atilla Özkan, MD. 1.
1 Nursing Care of Patients with Hematologic Disorders.
Approach to a child with hepatomegaly Dr. Shreedhar Paudel May, 2009.
CIRRHOSIS OF LIVER PORTAL HYPERTENSION HEPATIC ENCHEPALOPATHY PART-ONE 1 TO 21 slides.
Common Childhood Infectious Diseases Skimmia Japonica Rubella PROF. FAHAD AL ZAMIL Professor & Consultant Pediatric Infectious Diseases King Khalid University.
EXAMINATIO N OF THE ABDOMEN. ABDOMEN: Inspection There should be adequate exposure of the abdomen for proper inspection. The patient should.
Chronic hepatitis in childhood Modes of presentation Acute onset jaundice and persisting Gradual development of signs of liver disease Asymptomatic finding.
Clinical assessment of Lymph node 1- History 2-Character of nodal enlargement 3-Associated symptoms 4-Physical Examination 5-Lab investigation.
Leukaemia 1. * Definition of leukemia: Leukemia is malignant proliferation of hematopoietic cells in the bone marrow followed by blood dissemination and.
Hepatomagaly in children Prof. Dr. Cengiz Canpolat Department of Pediatrics Division of Pediatric Hematology- Oncology.
Lymphadenopathy: Approach in the Community Dr Chanpasong Family Medicine CME Conference, Champasack Provincial Hospital, Pakse October 2012.
Objectives By the end lecture we will be able 1.To know what is normal liver and Spleen. 2. To know about various causes of hepatosplenomegaly.
Cancer Education Day May 13, Approach to Adenopathy and Splenomegaly Disclosures – None.
PLATELETS. PLETELET PHYSIOLOGY Platelets Production: Hematopoietic stem cell Megakaryoblast Megakaryocyte Fragmentation of cytoplasm Platelets.
ABDOMINAL EXAMINATION. 1. Anatomy 2. Regions 3. Common presenting symptoms 4. Examination Inspection Auscultation Percussion Palpation Liver and spleen.
Professor Hala Al-Rimawi JUST & KAUH Over view of childhood leukemia Discussion of a case of acute lymphoblastic leukemia The common signs.
Meera Ladwa. Persistent temperatures of > 38.3 ⁰ C Of more than 3 weeks duration Of unknown cause despite 1 week of inpatient investigations.
Lymphoid System Dr. Raid Jastania Dec, By the end of this session you should be able to: –Describe the components of the lymphoid system –List the.
Hematology and Hematologic Malignancies Cancer of the formed elements of the blood.
Assessment of the Abdomen By Freida Fuller-Jonap fulerjonap_f
Haema - Non Mal:1 Shashi: 03/00 Non Malignant WBC - Disorders.
Lymphadenopathy Lymphadenopathy Presented by : Bhajneesh Singh Bedi.
Diseases Of The Blood Prof.Ahmed Mohy. Red blood cell Disorder Anemia Reduction in RBCS &/or haemoglobin/unit volume of blood with low or normal blood.
About Leukemia… Leukemia refers to cancers of the blood or bone marrow characterized by an abnormal increase of white blood cells. Leukemia is a type.
Objective Data- Percuss Liver Span Measure the distance between the two marks Normal liver span (adult) 6-12cm – taller persons have longer livers – Men.
Myocarditis and pericarditis Dr Ali M Somily Prof Hanan A Habib.
Preliminary materials Practical Cytological and Histological Approach to Lymphoid Lesions Workshop 8, 55 th annual meeting Canadian Association of Pathologists.
Edward Camacho Mina 1061 MD4 WINDSOR UNIVERSITY HODGKIN LYMPHOMA.
Childhood Infectious Diseases Skimmia Japonica Rubella FAHAD AL ZAMIL Professor & Consultant Pediatric Infectious Diseases King Khalid University Hospital.
By Alana Padula. Leukaemia is cancer of the blood cells. It begins in the bone marrow when abnormal cells multiply out of control to such an extent.
Differential Diagnosis Farie. DIFFERENTIAL DIAGNOSES.
Serious, involuntary weight loss indicates serious illness underneath it -Loss of >10% of body weight in the last 6 months -Weight loss should not be.
HEMATOPATHOLOGY MODULE Prepared by Emmanuel R. de la Fuente, M.D.
-fatigue for 20 days. 25year old Pakistani male,Not known to have any chronic illness before, referred from Alkhurma Hospital. Pt. presented there complaining.
By Fatin Al-Sayes MD, MSc, FRCPath Consultant Hematology Assistant Professor.
Chapter 15 The Liver The liver lies in the upper right quadrant of the abdominal cavity and is the largest organ in the body. The functions of the liver.
Causes of Fever of Unknown Source Interactive Game! Family Medicine Specialist CME October 15-17, 2012 Pakse.
The Blood PART II - DISEASES AND DISORDERS OF BLOOD.
Clinical Manifestations of TB Pulmonary disease – Primary disease Occurs soon after the initial infection in areas of high TB transmission, often in children.
ID Case Conference January 30, 2008 Carlos M. Perez, MD, FACP Associate Professor of Medicine Pontificia Universidad Catolica de Chile.
LYMPHADENOPATHY & SPLENOMEGALY Martin H. Ellis MD Meir Hospital.
Primary Impression. Active Pulmonary TB and Gastrointestinal tuberculosis previous history of TB – No sputum AFB smear was done to see if the patient.
The Journey of Blood. Blood - the life source Slide 1: Blood is a scarce and vital resource which saves lives and improves the health of millions. Its.
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