Hepatomegaly is when you have an abnormally large liver. Hepatomegaly splenomegaly hepatosplenomegaly quizlet. Since these organs are so situated that on enlarging they soon become palpable, definite enlargements become helpful in differential diagnosis. However, massive enlargementssplenomegaly and especially hepatomegalyare caused by relatively few diseases, and the knowledge of this fact will greatly aid in arriving at a correct differential diagnosis by precluding from consideration a large group of diseases that could scarcely be the basis of such enlargement. This article cites 1 articles, 0 of which you can access for free at. The diagnosis is usually made after an incidental discovery of unexplained elevation of liver enzyme levels or when steatosis is noted on imaging e. The average liver span is 45 cm in newborns and 68 cm in children at 12 years of age. The differential diagnoses of a palpable liver and hepatomegaly are presented in box 1621. It is important to realize that the liver is easily palpated in most children at 12 cm below the right costal margin. It is smooth, uniform, nontender and descends to meet the palpating fingers on inspiration. Hepatomegaly in neonates and children american academy. Hepatomegaly article about hepatomegaly by the free.
Hepatomegaly is a technical name for enlarged liver. The laboratory evaluation included liver function tests, hepatitis panel, alphafetoprotein levels, human chorionic gonadotropin levels, carcinoembryonic antigen, and routine cancer markers. Often, hepatomegaly will present as an abdominal mass. What is the differential diagnosis of hepatomegaly. Enlarged liver definition hepatomegaly, otherwise known as an enlarged liver, is a clinical finding in which the liver is found to be larger than is normal, either by the physical exam from a physician or by imaging such as ct scan or ultrasound. The liver may be transiently enlarged in acute alcoholic hepatitis. To be updated when it is complete please like us on facebook, follow us on.
Sep 17, 2019 there are other ways your doctor can look for the cause of your enlarged liver. List the important diagnostic considerations in patients who have. Hepatosplenomegaly can occur as the result of acute viral hepatitis, infectious mononucleosis, and histoplasmosis or it can be the sign of a serious and. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly. Morphological changes in hepatolienal syndrome characterized mainly by hyperplasia of the reticulohistocytes liver and spleen, fibroplastic reaction, in some cases, infiltrativeproliferative and degenerative diseases of blood vessels processes. Common and important causes of hepatomegaly for doctors and medical students this page is currently being written and will be available soon. Use the serum albumin to ascitic albumin difference serum albumin minus ascites albumin to help differentiate the cause of ascites. Hepatomegaly general presentation hepatomegaly can. Hepatomegaly can represent intrinsic liver disease or may be the presenting physical finding of a generalized disorder. May 17, 2020 ministry of ayush released revised guidelines on central nomination of ayush courses government orders.
Rather than a disease in itself, hepatomegaly is a symptom or complication of other liver conditions, some of them lifethreatening. The differential diagnosis of hepatomegaly includes. Oct, 2008 hepatomegaly is caused by inflammation, infiltration, obstruction, storage abnormalities and vascular congestion. Assessment of splenomegaly differentials bmj best practice. For this reason, hepatomegaly is something to take seriously, as it points to an underlying problem that could be quite. Of note, the liver may be displaced downward by the diaphragm or thoracic contents leading to false impression of hepatomegaly. Thus, the prior probability of hepatomegaly depends entirely on the possible underlying disease states. See chapter, peritoneal abdominal paracentesis for more details. Hepatomegaly in the absence of signs of cld is unlikely to be due to cirrhosis. Vod is primarily a clinical diagnosis characterized by hepatomegaly or pain in the right upper quadrant, jaundice, ascites, and unexplained weight gain. To be updated when it is complete please like us on facebook, follow us on twitter or subscribe on youtube using the follow us buttons. The liver edge is normally palpable in children and thin adults and some patients may have a palpable right lobe of the liver. Systemic venous hypertension can also increase the risk for.
May 05, 2016 hepatomegaly is enlargement of the liver. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly free download as powerpoint presentation. Differentials of gross hepatomegaly include leukaemia and other reticulo. Click here to download free teaching notes on hepatomegaly. Diagnosis of hepatomegaly and splenomegaly transmission experiments with human volunteers have been invaluable in recognizing these two forms of hepatitis and establishing the epidemiology of the two diseases but are not practicable for the study of individual patients. Venoocclusive disease, which is a blockage in the small veins in your liver. Differential diagnosis hepatomegaly doctor answers on. He is also the innovation lead for the australian centre for health innovation at alfred health, a clinical adjunct associate professor at monash university, and the chair of the australian and new zealand intensive care society anzics education committee. Anatomic pathology reported a diagnosis of embryonal cell sarcoma with tumor free surgical margins and negative abdominal lymph node.
Differential diagnosis for hepatomegaly oxford medical. Hepatic vein thrombosis, a blockage of veins in your liver. Differential diagnosis of hepatosplenomegaly homeopathy. Churchills pocketbook of differential diagnosis is the best differential diagnosis book for medical students who are working or are looking forward to more of the clinical approach to the field. Hepatosplenomegaly commonly abbreviated hsm is the simultaneous enlargement of both the liver hepatomegaly and the spleen splenomegaly. Differential diagnosis of fever with hepatomegaly download here free healthcaremagic app to ask a doctor all the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Early diagnosis and treatment of children who have liver disease is important because specific treatments are available for some diseases that can prevent disease progression or.
A case of hepatomegaly article pdf available in postgraduate medical journal 83984. Hepatomegaly hepatomegaly is the condition of having an enlarged liver. He may use an ercp, a scope that checks for problems in the ducts tubes that carry bile. Diagnostic algorithm to arrive at the most common diagnoses for a neonate who has hepatomegaly. The etiology of the pain may be any of a large number of processes. Early diagnosis and treatment of children who have liver disease is important because specific treatments are available for some diseases that can prevent disease progression or hepatic failure. How you get treated for your enlarged liver depends on. The border of the liver can be found by palpation, percussion, and auscultation. Inflammation autoimmune disease bile acid enzyme defects canalicular bile acid transport defects infections virus, abscess idiopathic neonatal hepatitis. Evaluation of abdominal pain in the emergency department. Higginson, the geographical pathology of liver disease in man gastroenterology 57. Hepatitis a vaccine is also recommended for most cases of postexpo sure prophylaxis, although immunoglobulin is an acceptable alterna tive in some situations.
It is a non specific medical sign having many causes, which can broadly be broken down into infection, direct toxicity, hepatic tumours, or metabolic disorder. Hepatomegaly is the condition of having an enlarged liver. The pdf link is available at the last part of this post. For claims with a date of service on or after october 1, 2015, use an. He is also the innovation lead for the australian centre for health innovation at alfred health, a clinical adjunct associate professor at monash university, and the chair of the australian and new zealand intensive care society anzics education committee he is a cofounder of the australia and new zealand. Churchills pocketbook of differential diagnosis 4th. Differential diagnosis of nafld a short summary naspghan.
For differential diagnosis medical students must have churchills pocketbook of differential diagnosis on their study table. What is a presumptive and differential diagnosis for influenza. The differential diagnosis of hepatomegaly and splenomegaly. Presentation hepatomegaly causes of hepatomegaly hepatitis o infections viral hepatitis acute and chronic ebv and cmv malaria abscesses amoebic or pyogenic autoimmune hepatitis alcoholic liver disease non alcoholic fatty liver disease previously known as nash tumours o metastases. The best way to assess size is by percussion a normalsized liver can appear. Diagnosis, differential glycogen storage diseasediagnosis hepatomegaly humans. Hepatomegaly refers to an increase in size or enlargement of the liver. Here is a case of hepatomegaly and splenomegaly presented from his case records by dr. Hepatomegaly can result from a vast range of pathology including, but not limited to, the following. Depending on the cause, it may sometimes present along with jaundice. Evaluation of abdominal pain in the emergency department hartmut gross, m. A normal liver should feel soft and is easily moveable upon inspiration. Hepatomegaly pediatrics clerkship the university of chicago.
Jun 18, 2007 a diagnosis of hepatic amyloidosis was made. Presentation hepatomegaly causes of hepatomegaly hepatitis o infections viral hepatitis acute and chronic ebv and cmv malaria abscesses amoebic or pyogenic autoimmune hepatitis alcoholic liver disease non alcoholic fatty liver disease previously known as nash tumours o metastases o hepatocellular carcinoma hcc. Hepatomegaly definition of hepatomegaly by the free. Hepatosplenomegaly can occur as the result of acute viral hepatitis, infectious mononucleosis, and histoplasmosis or it can be the sign of a serious and lifethreatening lysosomal storage disease.
Let us share with you people a famous series diagnosis book churchills pocketbook of differential diagnosis pdf 4th edition pdf free along with download link. Hepatomegaly american academy of pediatrics textbook of. May 17, 2020 ministry of ayush released revised guidelines on central nomination of ayush courses government orders may 16, 2020 kuhs recruitment of controller of examinations ayush jobs may 14, 2020 no salary or stipend deduction during lockdown period in homoeopathy medical colleges cch government orders. Diagnosis, differential glycogen storage disease diagnosis hepatomegaly. Hepatomegaly definition of hepatomegaly by the free dictionary. Hepatomegaly in neonates and children american academy of. Your child is being treated for this condition and symptoms get worse or new symptoms develop, mainly cough, chest pain, weight loss, or persistent fevers. Hepatomegaly in the absence of signs of cld is unlikely to be. Differential diagnosis of fever with hepatomegaly doctor. This can cause hepatomegaly affecting either the whole of the liver or occasionally only he left lobe. Hepatomegaly is caused by inflammation, infiltration, obstruction, storage abnormalities and vascular congestion. Anatomic pathology reported a diagnosis of embryonal cell sarcoma with tumor free surgical margins and negative abdominal lymph node biopsies. Describe what clinical findings occurring concomitantly in a patient who has. Hepatomegaly is a symptom that can be caused by a variety of conditions that affect different organ systems.
Chris is an intensivist and ecmo specialist at the alfred icu in melbourne. It is a nonspecific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. Sasskortsak, evaluation of the radioactive rose bengal test for the differential diagnosis of obstructive jaundice in infants new eng. As the name implies, its a condition in which the liver is enlarged or swollen. Many of these causes will be benign and selflimited, while others are medical urgencies or even surgical emergencies. Hepatomegaly is enlargement of the liver beyond its normal size and occurs mainly as a consequence of pathologic conditions.
An enlarged liver rarely presents alone and usually accompanies other clinical signs and symptoms based on the underlying pathophysiology. Hepatomegaly differential diagnosis things you didnt know. There are other ways your doctor can look for the cause of your enlarged liver. The most common sonographic signs of fetal syphilis hepatomegaly, ascites, hydrops, fetal anemia, polyhydramnios, and placentomegaly are associated with a higher risk of treatment failure 10 further with a higher risk of congenital syphilis at delivery 11.
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