🔺CASE STUDY : NO 47 🔺 PART NO :1 🔺 PLIHA ROGAS( SPLEEN DISORDERS) 🔺 NIDANA (ETIOLOGY / CAUSES) • Excessive intake of: -Amla, Katu, Tikta, Ruksha, Ushna, and Laghu Ahara -Dry food items -Suppression of natural urges, especially Adhovata -Excessive physical activity or weight lifting -Chronic fevers or chronic illnesses affecting Rakta Dhatu -Worm infestations (Krimi) -Alcoholic beverages (excessive Madya Sevanam) References:Charaka Samhita Chikitsa Sthana 13 – Udara Chikitsa Sushruta Samhita Uttara Tantra – Pliha Roga 🔺 POORVAROOPAM (PRODROMAL SYMPTOMS) -Aruchi (loss of taste) -Daurbalya (general weakness) -Aalasya (lethargy) -Udaragauravam (feeling of heaviness in the abdomen) -A mild enlargement of spleen without significant discomfort 🔺LAKSHANA (CLINICAL FEATURES) -Udarasya vamabhage sthiram kathamchit vardhamanam granthivad (Palpable, gradually enlarging mass in the left hypochondrium) -Ruja (pain) -Daha (burning sensation) -Vidaha, Arochaka (indigestion, anorexia) -Panduta (pallor, anemia) -Udara Vriddhi (enlargement of abdomen) -Krishata (emaciation) -Trishna (excessive thirst) -Vibandha or Atisara (constipation or diarrhea, depending on dosha) -Mala-Mutra Dourgandhya (foul-smelling stool and urine) Reference:Charaka Samhita, Chikitsa Sthana 13/26–27 Madhava Nidana, Chapter 33 – Udara Roga 🔺 SYSTEMIC EXAMINATION (CLINICAL EVALUATION) *General Physical Examination -Pallor – May indicate anemia (due to hypersplenism). -Icterus – If associated with hemolytic disorders. -Fever – May be present in infections (e.g., malaria, typhoid, tuberculosis). -Weight loss – In chronic diseases like lymphoma or leukemia. -Fatigue, Weakness – Due to anemia or systemic disease. *Abdominal Examination -Inspection: Abdominal distension or asymmetry. -Prominent veins (suggesting portal hypertension). *Palpation: *Splenomegaly: Enlarged spleen palpable under the left costal margin. *May be soft (e.g., infections), firm (e.g., cirrhosis), or hard (e.g., malignancy). -Tenderness: Suggests acute pathology (e.g., splenic infarct, abscess). *Percussion: -Dullness in Traube’s space indicates splenomegaly. *Auscultation: -Bruit may be heard in vascular tumors or arteriovenous malformations. 🔺 LABORATORY EXAMINATION *Hematological Tests -Complete Blood Count (CBC): -Anemia, leukopenia, thrombocytopenia (in hypersplenism). -Pancytopenia in conditions like leukemia or myelofibrosis. *Peripheral Blood Smear: -Abnormal cells in leukemia/lymphoma. -Spherocytes in hemolytic anemia. -Malarial parasites. -Reticulocyte Count – Elevated in hemolysis. *Biochemical Tests -Liver Function Tests (LFTs) – For portal hypertension or liver disease. -Lactate Dehydrogenase (LDH) – Raised in hemolysis, lymphoma. -Serum Ferritin, Iron Studies – To assess for anemia type. -Serology and PCR – For infections (e.g., HIV, EBV, CMV, malaria, leishmaniasis). *Imaging -Ultrasound Abdomen – First-line to assess splenomegaly, masses, infarcts. -CT/MRI Abdomen – Better anatomical details; useful for tumors, abscesses, cysts. -Bone Marrow Aspiration/Biopsy – If hematological malignancy suspected. 📌 Expected Outcomes -The prognosis of splenic diseases depends on the underlying cause: -Infectious causes (e.g., malaria, typhoid): Good prognosis with treatment. -Hypersplenism: Correctable with splenectomy in selected cases. -Hematological malignancies (e.g., leukemia, lymphoma): Variable; depends on stage and treatment. -Splenic rupture or infarct: Potentially life-threatening without intervention. -Autoimmune or hemolytic anemias: Often manageable with immunosuppressive therapy or splenectomy. 🛑https://chat.whatsapp.com/JtHGdxv7A5SA9bAe8ZNIS2