Enlargement of the liver
Medical condition
Hepatomegaly is enlargement of theliver .[ 4] medical sign , having many causes, which can broadly be broken down intoinfection ,hepatic tumours , andmetabolic disorder . Often, hepatomegaly presents as anabdominal mass . Depending on the cause, it may sometimes present along withjaundice .[ 1]
The patient may experience many symptoms, including weight loss,poor appetite , andlethargy ;jaundice and bruising may also be present.[ 1]
Leptospirosis Among the causes of hepatomegaly are the following:
Neoplastic
Biliary
Metabolic
Congenital
Others The mechanism of hepatomegaly consists ofvascular swelling,inflammation (infectious in origin), and deposition of (1) non-hepatic cells or (2) increased cell contents (such as that due to iron inhemochromatosis orhemosiderosis and fat in fatty liver disease).[ 15]
Abdominal ultrasonography of the liver, as asagittal plane through themidclavicular line , with some standard measurements[ 2] Right lobe of the liver at themidclavicular line at ages 0 to 7[ 16] Suspicion of hepatomegaly indicates a thoroughmedical history andphysical examination , wherein the latter typically includes an increasedliver span .[citation needed
Onabdominal ultrasonography , the liver can be measured by themaximum dimension on asagittal plane view through themidclavicular line , which is normally up to 18 cm in adults.[ 2] cranio-caudal dimension[ 2] ventro-dorsal dimensiondepth ), which is normally up to 13 cm.[ 2] caudate lobe is enlarged in many diseases. In theaxial plane , the caudate lobe should normally have a cross-section of less than 0.55 of the rest of the liver.[ 2]
Otherultrasound studies have suggested hepatomegaly as being defined as a longitudinal axis > 15.5 cm at the hepatic midline, or > 16.0 cm at themidclavicular line .[ 17] [ 18]
Blood tests should be done, especiallyliver-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 extrahepaticbile-duct obstruction .[ 19] ultrasound of the liver can reliably detect a dilatedbiliary-duct system,[ 20] cirrhotic liver .[ 21]
Computerized tomography (CT) can give accurateanatomical 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 andazathioprine 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 conjugatevaccine is used in some cases.[ 23]
In primary biliary cirrhosis,ursodeoxycholic acid helps the bloodstream remove bile, which may increase survival.[ 24]
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