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1) Patient is supine on the table with the abdominal area open from the costal margin to the level of the ASIS.
Showing the Enlargement of Spleen below the Left Costal Margin
abdominal girth (central point between the lower costal margin and the superior iliac crest should be less than 35.
2 kg, head circumference 39 cm, and length 53 cm; she revealed pallor, cleft lip, hepatomegaly (span 8 cm), and grade II splenomegaly (palpable 6 cm below left costal margin from midclavicular line).
Finally, 5-mm trocars were placed at auxiliary operating sites located 2 cm above the umbilicus along the right clavicular midline, below the costal margin along the left clavicular midline, and below the costal margin along the right clavicular midline.
Forewing ground color white; costal margin smooth, brown; barely falcate at apex; subbasal fascia gray and weakly marked; antemedial fascia light color and broad; medial fascia dark color and rather broad; postmedial fascia dark color, broad and slight excurved in middle; subterminal fascia slender, grayish brown; cilia short, grayish white.
The physical examination was abnormal with peripheral lymphadenopathy in both laterocervical and left axillary spleen and liver enlargement being noted: the liver edge palpated 2 cm below the right costal margin the spleen at 3 cm below left costal margin confirmed by ultrasound.
9 times as broad as long, lateral margins, straight, flattened and distinctly raisedwith fifteen long, acute, upwardly projecting spines ofunequal length; costal margin of hemelytra yellow, callus with three short stout yellowish teeth, connexiva black, with exterior margin along whole length yellow, moderately raised, armed with 5-6 teeth on each connexivum M.
There was mild hepatosplenomegaly (liver 3 cm below costal margin, spleen 2.
Physical examination revealed the spleen 2 cm below the costal margin.
The arc incision from the xiphoid process to right inferior costal margin was performed.
Wing with costal margin broadly infuscate, lacking distinct infuscation over apex of [R.