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]
Signs and symptoms
The patient may experience many symptoms, including weight loss,
poor appetite , and
lethargy ;
jaundice and bruising may also be present.
[1]
Causes
Leptospirosis
Among the causes of hepatomegaly are the following:
Infective
Neoplastic
Biliary
Metabolic
Drugs (including alcohol)
Congenital
Others
Mechanism
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]
Diagnosis
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]
Workup
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]
Treatment
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]
See also
References
^
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 .
^
"Sarcoidosis | Doctor | Patient" . Patient .
Archived from the original on 2016-03-11. Retrieved 2016-03-11 .
^ 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 .
^
^ 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 .
^
"Non-Hodgkin's Lymphoma | Doctor | Patient" . Patient .
Archived from the original on 2018-02-08. Retrieved 2016-03-11 .
^
"Primary biliary cirrhosis: MedlinePlus Medical Encyclopedia" . www.nlm.nih.gov .
Archived from the original on 2016-07-05. Retrieved 2016-03-12 .
Further reading
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 .
External links
Classification External resources