Enlargement of the liver
Medical condition
Hepatomegaly is enlargement of the liver .[ 4] It is a non-specific medical sign , having many causes, which can broadly be broken down into infection , hepatic tumours , and metabolic disorder . Often, hepatomegaly presents as an abdominal mass . Depending on the cause, it may sometimes present along with jaundice .[ 1]
The patient may experience many symptoms, including weight loss, poor appetite , and lethargy ; jaundice and bruising may also be present.[ 1]
Leptospirosis Among the causes of hepatomegaly are the following:
Neoplastic
Biliary
Drugs (including alcohol)
Congenital
Others
The mechanism of hepatomegaly consists of vascular swelling, inflammation (infectious in origin), and deposition of (1) non-hepatic cells or (2) increased cell contents (such as that due to iron in hemochromatosis or hemosiderosis and fat in fatty liver disease).[ 15]
Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line , with some standard measurements[ 2] Right lobe of the liver at the midclavicular line at ages 0 to 7[ 16] Suspicion of hepatomegaly indicates a thorough medical history and physical examination , wherein the latter typically includes an increased liver span . [citation needed ]
On abdominal ultrasonography , the liver can be measured by the maximum dimension on a sagittal plane view through the midclavicular line , which is normally up to 18 cm in adults.[ 2] It is also possible to measure the cranio-caudal dimension , which is normally up to 15 cm in adults.[ 2] This can be measured together with the ventro-dorsal dimension (or depth ), which is normally up to 13 cm.[ 2] Also, the caudate lobe is enlarged in many diseases. In the axial plane , the caudate lobe should normally have a cross-section of less than 0.55 of the rest of the liver.[ 2]
Other ultrasound studies have suggested hepatomegaly as being defined as a longitudinal axis > 15.5 cm at the hepatic midline, or > 16.0 cm at the midclavicular line .[ 17] [ 18]
Blood tests should be done, especially liver-function tests , which give a good impression of the patient's broad metabolic picture.[medical citation needed ]
A complete blood test can help distinguish intrinsic liver disease from extrahepatic bile-duct obstruction .[ 19] An ultrasound of the liver can reliably detect a dilated biliary-duct system,[ 20]
it can also detect the characteristics of a cirrhotic liver .[ 21]
Computerized tomography (CT) can give accurate anatomical information for a complete diagnosis.[ 22]
Prednisone Treatment of hepatomegaly varies with the cause, so accurate diagnosis is the first concern. In auto-immune liver disease, prednisone and azathioprine may be used for treatment.[ 3]
In lymphoma the treatment options include single-agent (or multi-agent) chemotherapy and regional radiotherapy, and surgery is an option in specific situations. Meningococcal group C conjugate vaccine is used in some cases.[ 23]
In primary biliary cirrhosis, ursodeoxycholic acid helps the bloodstream remove bile, which may increase survival.[ 24]
^ a b c d e f g h i j k l m n o p q r s "Hepatomegaly. Read about Hepatomegaly (enlarged liver) | Patient" . Patient . Archived from the original on 2022-02-01. Retrieved 2016-02-27 .
^ a b c d e f Christoph F. Dietrich, Carla Serra, Maciej Jedrzejczyk (2010-07-28). "Ultrasound of the liver - EFSUMB – European Course Book" (PDF) . European federation of societies for ultrasound in medicine and biology (EFSUMB) . Archived from the original (PDF) on 2017-08-12. Retrieved 2017-12-21 . ((cite web ))
: CS1 maint: multiple names: authors list (link )
^ a b "Cirrhosis: Practice Essentials, Overview, Etiology" . Medscape . 22 July 2021. Retrieved 16 May 2024 .
^ a b c d e f g h i "Hepatomegaly: MedlinePlus Medical Encyclopedia" . www.nlm.nih.gov . Archived from the original on 2016-07-05. Retrieved 2016-02-27 .
^ Lang, Florian (2009-03-19). Encyclopedia of Molecular Mechanisms of Disease: With 213 Tables . Springer Science & Business Media. p. 824. ISBN 9783540671367 . Archived from the original on 2023-01-12. Retrieved 2016-03-11 .
^ Prevention, CDC - Centers for Disease Control and. "CDC - Echinococcosis - Resources for Health Professionals" . www.cdc.gov . Archived from the original on 2016-03-11. Retrieved 2016-03-11 .
^ "Leptospirosis (Weil's Disease) | Doctor | Patient" . Patient . Archived from the original on 2016-03-11. Retrieved 2016-03-11 .
^ Banfalvi, Gaspar (2013-10-16). Homeostasis - Tumor - Metastasis . Springer Science & Business Media. p. 145. ISBN 9789400773356 .
^ "Cholesteryl Ester Storage Disease - NORD (National Organization for Rare Disorders)" . NORD (National Organization for Rare Disorders) . Archived from the original on 2016-03-12. Retrieved 2016-03-11 .
^ Sherigar, JM; Castro, J; Yin, YM; Guss, D; Mohanty, SR (27 February 2018). "Glycogenic hepatopathy: A narrative review" . World Journal of Hepatology . 10 (2): 172–185. doi :10.4254/wjh.v10.i2.172 . PMC 5838438 . PMID 29527255 .
^ "Hunter's Syndrome. MPS II information; symptoms | Patient" . Patient . 20 August 2014. Archived from the original on 2016-03-12. Retrieved 2016-03-11 .
^ "OMIM Entry - # 214100 - PEROXISOME BIOGENESIS DISORDER 1A (ZELLWEGER); PBD1A" . www.omim.org . Archived from the original on 2015-02-14. Retrieved 2016-03-11 .
^ "CPT I deficiency" . Genetics Home Reference . 2016-03-07. Archived from the original on 2020-09-19. Retrieved 2016-03-11 .
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^ Dennis, Mark; Bowen, William Talbot; Cho, Lucy (2012-01-01). Mechanisms of Clinical Signs . Elsevier Australia. p. 469. ISBN 9780729540759 . Archived from the original on 2023-01-12. Retrieved 2020-10-25 .
^ Rocha, Silvia Maria Sucena da; Ferrer, Ana Paula Scoleze; Oliveira, Ilka Regina Souza de; Widman, Azzo; Chammas, Maria Cristina; Oliveira, Luiz Antonio Nunes de; Cerri, Giovanni Guido (2009). "Determinação do tamanho do fígado de crianças normais, entre 0 e 7 anos, por ultrassonografia" . Radiologia Brasileira . 42 (1): 7–13. doi :10.1590/S0100-39842009000100004 . ISSN 0100-3984 .
^ Gosink, BB; Leymaster, CE (January 1981). "Ultrasonic determination of hepatomegaly". Journal of Clinical Ultrasound . 9 (1): 37–44. doi :10.1002/jcu.1870090110 . PMID 6792230 . S2CID 22827636 .
^ Kratzer, W; Fritz, V; Mason, RA; Haenle, MM; Kaechele, V; Roemerstein Study, Group. (November 2003). "Factors affecting liver size: a sonographic survey of 2080 subjects" . Journal of Ultrasound in Medicine . 22 (11): 1155–61. doi :10.7863/jum.2003.22.11.1155 . PMID 14620885 . S2CID 29904060 .
^ Goldman, Lee; Schafer, Andrew I. (2015-04-21). Goldman-Cecil Medicine . Elsevier Health Sciences. p. 991. ISBN 9780323322850 .
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^ Murray, Karen F.; Horslen, Simon (2013-12-11). Diseases of the Liver in Children: Evaluation and Management . Springer Science & Business Media. p. 199. ISBN 9781461490050 .
^ Mirvis, Stuart E.; Soto, Jorge A.; Shanmuganathan, Kathirkamanathan; Yu, Joseph; Kubal, Wayne S. (2014-08-19). Problem Solving in Emergency Radiology . Elsevier Health Sciences. p. 442. ISBN 9781455758395 .
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Hoffmann, Georg F.; Zschocke, Johannes; Nyhan, William L. (2009-11-21). Inherited Metabolic Diseases: A Clinical Approach . Springer Science & Business Media. ISBN 9783540747239 .
Kim, Sun Bean; Kim, Do Kyung; Byun, Sun Jeong; Park, Ji Hye; Choi, Jin Young; Park, Young Nyun; Kim, Do Young (2015-12-01). "Peliosis hepatis presenting with massive hepatomegaly in a patient with idiopathic thrombocytopenic purpura" . Clinical and Molecular Hepatology . 21 (4): 387–392. doi :10.3350/cmh.2015.21.4.387 . ISSN 2287-2728 . PMC 4712167 . PMID 26770928 .
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