Hepatomegaly

Hepatomegaly
Computerized tomography of hepatomegaly
Classification and external resources
Specialty	internal medicine
ICD-10	R16..0
ICD-9-CM	789.1
MedlinePlus	003275
Patient UK	Hepatomegaly

Hepatomegaly is the condition of having an enlarged liver. 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. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.

Causes

Infective

Glandular fever (Infectious mononucleosis) This is caused by the Epstein-Barr virus (EBV). A similar condition (pseudoglandular fever) may be caused by cytomegalovirus (CMV).
Hepatitis (Although not all hepatitis viruses cause hepatomegaly)
Liver abscess (pyogenic abscess and amoebic abscess)
Malaria
Amoeba infections
Hydatid cyst
Leptospirosis
Actinomycosis

Neoplastic

Metastatic tumours secondary to spread from cancer in other organs (most common)
Hemangiomas
Hepatocellular carcinoma
Myeloma
Leukemia
Lymphoma
hepatoma

Cirrhotic

Portal
Biliary
Cardio
Haemochromatosis

Metabolic

Fatty infiltration
Lysosomal acid lipase deficiency, also known as Wolman disease or cholesteryl ester storage disease
Amyloidosis
Gaucher's disease
Niemann Pick disease
Von Gierke disease (Glycogen Storage Disease type 1)
Glycogen Storage Disease types III, VI and IX

Drugs and toxins

Congenital

Hemolytic anemia
Riedel's lobe is an extended, tongue-like, right lobe of the liver. It is not pathological; it is a normal anatomical variant and may extend into the pelvis. It is often mistaken for a distended gall bladder or liver tumour.
Polycystic disease
Cori's disease

Others

Diagnosis

A suspicion of hepatomegaly indicates a thorough medical history and physical examination, wherein the latter typically includes an increased liver span. Blood tests should be done, importantly liver-function series, which will give a good impression of the patient's broad metabolic picture.

An ultrasound of the liver can reliably detect a dilated biliary-duct system, which helps distinguish parenchymal liver disease from extrahepatic bile-duct obstruction. Ultrasound can also detect the characteristic texture of a cirrhotic liver, and can guide fine-needle aspiration of cysts, abscesses and tumours.

Computed tomography or (computerized tomography) (CT) can help to obtain more accurate anatomical information, and is unaffected by obesity or the presence of bowel gases.

External links

Symptoms and signs: digestive system and abdomen (R10–R19, 787,789)

Upper	Nausea Vomiting Heartburn Aerophagia Dysphagia oropharyngeal esophageal Odynophagia Halitosis Xerostomia Hypersalivation Burping Wet burp

Defaecation	Flatulence Fecal incontinence Encopresis Blood: Fecal occult blood Rectal tenesmus Constipation Obstructed defecation Diarrhea Rectal discharge Football sign Psoas sign Obturator sign Rovsing's sign Heel tap sign Aure-Rozanova's sign Dunphy sign Alder's sign Lockwood's sign Rosenstein's sign

Abdomen	Abdominal pain Acute abdomen Colic Baby colic Abdominal guarding Rebound tenderness Abdominal distension Bloating Ascites Tympanites Shifting dullness Bulging flanks Fluid wave test Abdominal mass Hepatosplenomegaly Hepatomegaly Splenomegaly Jaundice Mallet-Guy sign Puddle sign

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