Physical examination showed discrete hepatomegaly and significant splenomegaly, about 20 cm below the left costal margin
. He reported having lived in the cities of Londrina/PR and Itaituba/PA, where he worked in mining for about seven months a year.
Her physical examination is unremarkable, with the exception of her grade 2/6 systolic ejection murmurs at the upper right sternal border and an enlarged spleen, which spans 10 cm below her left costal margin
. Her liver span is normal.
Physical examination was notable for a palpable spleen 5 fingerbreadths below the left costal margin
. No palpable adenopathy was present.
The abdomen was nontender, the liver was palpated 4 cm below the right costal margin, and the spleen was markedly enlarged, firm, and extended 26 cm below the left costal margin
Per Abdomen Exam--Massive Splenomegaly reaching Up To Umbilicus 15 Cm Below Left Costal Margin
Spleen was palpable 1 cm below the left costal margin
. Other systemic examination was normal.
Physical exam showed pallor, icterus, and spleen palpable 7 cm below the left costal margin
The spleen was palpable 3 cm below the left costal margin
. On central nervous examination, he was conscious and well-oriented in time, place and person.
Spleen size regressed to 2 cm below the left costal margin.
His anemia progressed to Hb 68 g/L after two weeks, at which time the spleen became palpable up to 4 cm below the left costal margin. Peripheral blood smear showed predominantly normocytic, normochromic RBCs with small numbers of teardrop poikilocytes and nucleated RBCs.
On examination, he had pallor, splenomegaly 3 cm below the left costal margin, and no lymphadenopathy or bleeding manifestations.