26 yrold pt presented with nausea, indigestion, abdominal discomfort, fatigability insomnia o/e moderate splenomegaly how Will you approach the case and what precautions you will advise



Summer boil..with fungal infections

Fungal infections...or cloth allergy

Hepato-spleenomegy.i..pancratitis; Malariae infection.

Sickle thalassemia which can cause splenomegaly Hemolysis can lead to gall stones Fatigue explained with anemia

As HB f is very high with huge splenomegaly & gall stone diagnosis stands alone Sickle Cell Aneamia

SICKLE CELL ANAEMIA WITH GALLSTONES.. In pt of sickle cell anaemia, there is constant break down of RBC ,which leads to excess bilirubin formation. This will leads to bilirubin sludge,in duct this can leads to gallstones formation.. Spleenomegaly,probably due to sickle cell anaemia. Better to do Cholecystectomy, with experts opinion .. .

Thanks a lot sir Dr Kailash Sahare

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Sickle cell anaemia with pigmented gall bladder stone and splenomegaly

Gall stone with splenomegaly. Sickle cell anaemia.

Thanks Dr Ved sharma.

Sickle cell disease! Gallbladder stone!,take family history and present complain.manage symptomatic.if anemia then blood transfusion ,o2 supply, once pt stabiliz then counsel for laprotomy for splenectomy and cholecystectomy.but do vaccination before splenectomy for influenza, streptococcus meningococcus flora.

Sickle cell anemia with Pigemented gall stones and splenomegaly . Splenomegaly may be due to sickle cell crisis - splenic vein thrombosis. Spleen can undergo autosplenectomy. Gall stones again common with sickle cell anemia go for cholecystectomy . If splenomegaly doesn't resolve or associated with hypersplenism associated with pancytopenia go for splenectomy . Immunisation against CAPSULATED organisms like H.INFLUENZAE , MENINGOCOCCI STREPTOCOCCUS is necessary before splenectomy. If severe pain persists give an opioid analgesic. Avoid sickle cell crisis by avoiding cold temperature , hypoxic environment like mountain climbing.

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