Hepatomegaly: Difference between revisions
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== Causes == | == Causes == | ||
Hepatomegaly may be classified on the basis of etiology into hepatitis, storage disorders, impaired venous outflow, infiltrative and obstructive causes. | Hepatomegaly may be classified on the basis of etiology into hepatitis, storage disorders, impaired venous outflow, infiltrative and obstructive causes.<ref name="pmid10970452">{{cite journal |vauthors=Wolf AD, Lavine JE |title=Hepatomegaly in neonates and children |journal=Pediatr Rev |volume=21 |issue=9 |pages=303–10 |year=2000 |pmid=10970452 |doi= |url=}}</ref><ref name="pmid16454833">{{cite journal |vauthors=Chau TN, Lai ST, Tse C, Ng TK, Leung VK, Lim W, Ng MH |title=Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A |journal=Am. J. Gastroenterol. |volume=101 |issue=2 |pages=292–6 |year=2006 |pmid=16454833 |doi=10.1111/j.1572-0241.2006.00416.x |url=}}</ref><ref name="pmid23485521">{{cite journal |vauthors=Bernstein DL, Hülkova H, Bialer MG, Desnick RJ |title=Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease |journal=J. Hepatol. |volume=58 |issue=6 |pages=1230–43 |year=2013 |pmid=23485521 |doi=10.1016/j.jhep.2013.02.014 |url=}}</ref><ref name="pmid16625098">{{cite journal |vauthors=Torbenson M, Chen YY, Brunt E, Cummings OW, Gottfried M, Jakate S, Liu YC, Yeh MM, Ferrell L |title=Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus |journal=Am. J. Surg. Pathol. |volume=30 |issue=4 |pages=508–13 |year=2006 |pmid=16625098 |doi= |url=}}</ref><ref name="pmid8982149">{{cite journal |vauthors=Chatila R, West AB |title=Hepatomegaly and abnormal liver tests due to glycogenosis in adults with diabetes |journal=Medicine (Baltimore) |volume=75 |issue=6 |pages=327–33 |year=1996 |pmid=8982149 |doi= |url=}}</ref> | ||
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!Etiology | !Etiology | ||
Revision as of 22:04, 26 January 2018
For patient information on this topic, click here.
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Hepatomegaly Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Iqra Qamar M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]
Synonyms and keywords: Enlarged liver; liver enlargement
Overview
Causes
Hepatomegaly may be classified on the basis of etiology into hepatitis, storage disorders, impaired venous outflow, infiltrative and obstructive causes.[1][2][3][4][5]
| Etiology | Disease | |
|---|---|---|
| Hepatitis | Infections | Acute and chronic viral hepatitis |
| Bacterial liver abscess | ||
| Parasitic infections | ||
| Granulomatous hepatitis | ||
| Ischemia | Ischemic hepatitis ("shock liver") | |
| Toxins | Alcoholic hepatitis | |
| Steatosis | Alcoholic fatty liver disease | |
| Nonalcoholic steatohepatitis | ||
| Drugs/Medications | Drug induced liver injury (DILI) | |
| Immune mediated hepatitis | Autoimmune hepatitis | |
| Copper deposition | Wilson disease | |
| Storage disorders | Glycogen | Glycogen storage disorders |
| Diabetes mellitus | ||
| Lipid | Gaucher disease | |
| Nonalcoholic steatohepatitis | ||
| Protein | Alpha-1 antitrypsin deficiency | |
| Iron | Hemochromatosis | |
| Impaired venous outflow | Cardiac | Right heart failure |
| Constrictive pericarditis | ||
| Hepatic vein | Hepatic vein thrombosis | |
| Inferior vena cava web | ||
| Intrahepatic | Sinusoidal obstruction syndrome | |
| Peliosis hepatis | ||
| Infiltrative diseases | Benign primary liver tumors | Hemangiomas |
| Adenomas | ||
| Focal nodular hyperplasia | ||
| Malignant primary liver tumors | Hepatocellular carcinoma | |
| Cholangiocarcinoma | ||
| Fibrolamellar carcinoma | ||
| Hemangioendothelioma | ||
| Metastatic/disseminated tumors | Myeloma | |
| Lymphoma | ||
| Leukemia | ||
| Metastatic solid tumors | ||
| Biliary obstruction | Primary biliary cirrhosis | |
| Primary sclerosing cholangitis | ||
| Biliary atresia | ||
| Other | Anatomic variations | Riedel's lobe |
| Cystic liver disease | Polycystic liver disease | |
| Caroli's disease | ||
Differential diagnosis
Patients with hepatomegaly need to be differentiated from other patients presenting with similar complaints such as abdominal pain.
Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram, US = Ultrasound
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Diagnostic workup
- ↑ Wolf AD, Lavine JE (2000). "Hepatomegaly in neonates and children". Pediatr Rev. 21 (9): 303–10. PMID 10970452.
- ↑ Chau TN, Lai ST, Tse C, Ng TK, Leung VK, Lim W, Ng MH (2006). "Epidemiology and clinical features of sporadic hepatitis E as compared with hepatitis A". Am. J. Gastroenterol. 101 (2): 292–6. doi:10.1111/j.1572-0241.2006.00416.x. PMID 16454833.
- ↑ Bernstein DL, Hülkova H, Bialer MG, Desnick RJ (2013). "Cholesteryl ester storage disease: review of the findings in 135 reported patients with an underdiagnosed disease". J. Hepatol. 58 (6): 1230–43. doi:10.1016/j.jhep.2013.02.014. PMID 23485521.
- ↑ Torbenson M, Chen YY, Brunt E, Cummings OW, Gottfried M, Jakate S, Liu YC, Yeh MM, Ferrell L (2006). "Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus". Am. J. Surg. Pathol. 30 (4): 508–13. PMID 16625098.
- ↑ Chatila R, West AB (1996). "Hepatomegaly and abnormal liver tests due to glycogenosis in adults with diabetes". Medicine (Baltimore). 75 (6): 327–33. PMID 8982149.