Mahmoud A Alhussini is a lecturer in general surgery department, Alexandria faculty of Medicine in Egypt. He succeded to finish his Ms thesis in 2010 from Alexandria University. He completed his Md in 2014 from Alexandria University also. He was trained in Alexandria Main Universty Hospital which is a tertiary refferal hospital for more than 3 governates in Egypt including the second,capital.


Bilharzial hepatic fibrosis is an endemic disease in Egypt. This disease affects the liver both anatomically and functionally. There is portal hypertension together with bleeding tendency. Portal hypertension causes backflow in the portal circulation. Thus, collaterals are formed in many sites including the retroperitoneum and abdominal wall. Splenomegaly is another consequence. This enlarged spleen is more vulnerable to trauma and rupture. Conservative measures usually fail. Also, splenorraphy is unreliable. Furthermore, this enlarged spleen is complicated by hypersplenism in many cases. All these present a challenge in managing these patients if exposed to blunt abdominal trauma. Both conservative measures and interventions carry major risk to the patient. Hence, those patients should have special care during their managemnt.