Answer 28
An answer emailed by Dr. Eman Taha:
"..from
history the patient lives in village with huge splenomegaly I think that
is bilharzial spleen as there is normal liver enzymes but he may suffer
from attacks of haemolysis that lead to elevated bilirubin and
pancytopenia which is a complication of splenomegaly.."
-Excellent Dr.Eman you have touched the right answer...
Obviously
this patient had been exposed to bilharzial infection led to
splenomegaly (Egyptian splenomegaly) complicated by hypersplenism as
evidenced by the pancytopenia and the hemolysis...
The
splenectomy is mandatory in management of this patient after assurance
of the bone marrow cellularity and if possible the splenic
sequestration.
