Hepatomegaly

 ( Hepatology ) 

Hepatomegaly is enlargement of the liver. It is a non-specific medical sign, having many causes, which can broadly be broken down into infection, , and metabolic disorder. Often, hepatomegaly presents as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.

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Signs and symptoms The patient may experience many symptoms, including weight loss, poor appetite, and lethargy; jaundice and bruising may also be present.

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Causes

Among the causes of hepatomegaly are the following:

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Infective

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Mechanism

The mechanism of hepatomegaly consists of Blood vessel 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).

(2012). 9780729540759, Elsevier Australia. . ISBN 9780729540759

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Diagnosis

Suspicion of hepatomegaly indicates a thorough medical history and physical examination, wherein the latter typically includes an increased liver span.

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. It is also possible to measure the cranio-caudal dimension, which is normally up to 15 cm in adults. This can be measured together with the ventro-dorsal dimension (or depth), which is normally up to 13 cm. 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.

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.

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Workup

should be done, especially liver-function tests, which give a good impression of the patient's broad metabolic picture.

A complete blood test can help distinguish intrinsic liver disease from extrahepatic jaundice.

(2015). 9780323322850, Elsevier Health Sciences. . ISBN 9780323322850

An ultrasound of the liver can reliably detect a dilated bile duct system, it can also detect the characteristics of a liver cirrhosis.

(2013). 9781461490050, Springer Science & Business Media. . ISBN 9781461490050

Computerized tomography (CT) can give accurate anatomy information for a complete diagnosis.

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Treatment [[File:Prednisone2.png|140 px|thumb|left| 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.

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.

In primary biliary cirrhosis, ursodeoxycholic acid helps the bloodstream remove bile, which may increase survival.

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See also

• Hepatosplenomegaly
• Liver function tests

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Further reading

• (2009). 9783540747239, Springer Science & Business Media. . ISBN 9783540747239

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External links

• Merck Manual: Hepatomegaly