Hepatomegaly: Description, Causes and Risk Factors: HepatomegalyHepatomegaly is enlargement of the liver. The liver plays a key role in metabolism. It helps food to be absorbed by the intestines as well as removing toxic substances from the bloodstream. Sometimes the liver will enlarge when it becomes inflamed. Liver enlargement, by itself, is not a disease, but may a sign of an underlying disease. Possible Causes: Replication of hepatocytes in the form of excessive hyperplasia can occur occasionally after extensive parenchymal necrosis or partial liver resection. However, this does not generally cause a clinically discernible form of hepatomegaly.
  • In systemic hematological diseases, the liver is usually involved in extramedullary hematopoiesis. This can result in hepatomegaly. Diffuse hepatomegaly is also expected to occur as a result of malignant cell growth.
  • Endothelia and Kupffer cells can be stimulated to considerable proliferation, so that in clinical terms hepatomegaly occasionally results.
  • Proliferation of smooth endoplasmic reticulum due to the prolonged induction of the biotransformatory system localized at this site as a result of toxins, chemicals can bring about clinically and sonographically detectable hepatomegaly.
  • Hepatocellular storage of abnormal quantities of cholesterol, fat, glycogen, proteins, mucopolysaccharides, copper, iron, etc occasionally leads to pronounced hepatomegaly. Hydropic swelling of the hepatocytes is also included in this category.
  • A disorder of the bile flow, particularly in infants leads to extensive hepatomegaly.
  • An increase in the extracellular matrix due to collagens, elastin, proteoglycans, glycoprotein, etc also produces various degrees of hepatomegaly.
Possible Risk Factors: Cirrhosis.
  • Hepatitis caused by a virus — including hepatitis A, B and C — or caused by infectious mononucleosis.
  • Nonalcoholic fatty liver disease.
  • Alcoholic fatty liver disease.
  • A disorder that causes abnormal protein to accumulate in your liver (amyloidosis).
  • A disorder that causes copper to accumulate in your liver (Wilson's disease).
  • A disorder that causes iron to accumulate in your liver (hemochromatosis).
  • A disorder that causes fatty substances to accumulate in your liver (Gaucher disease)
  • Fluid-filled pockets in the liver (liver cysts).
  • Non-cancerous liver tumors, including hemangioma and adenoma.
  • Obstruction of the gallbladder or bile ducts.
  • Toxic hepatitis.
  • Leukemia.
  • Liver cancer.
  • Lymphoma.
  • Blockage of the veins that drain the liver (Budd-Chiari syndrome).
  • Heart failure.
  • Pericarditis (inflammation of the tissue surrounding the heart).
Failure to diagnose and treat the underlying cause of hepatomegaly can be fatal. There are many common-sense measures you can take to protect your liver. Some of the things you can do are: Exercise caution when drinking alcohol and consider not drinking at all. Discuss your drinking habits with your doctor to see if your intake is excessive.
  • Take vitamin supplements only as directed, and always discuss them with your doctor.
Symptoms: Symptoms of moderate-to-severe hepatomegaly may include: Nausea
  • Vomiting
  • Upper abdominal pain, usually right upper abdominal pain.
  • Ascites.
  • Right side flank pain.
  • Fatigue.
  • Fever.
  • Shaking and chills.
  • Itching.
  • Yellow skin.
  • Yellow eyes.
  • Brown urine.
  • Clay colored stool.
Diagnosis: Initial laboratory evaluation should include a complete blood count, electrolytes, creatinine, glucose, liver enzyme testing (alanine aminotransferase, aspartame transferase, ?-glutamyl transpeptidase, alkaline phosphatase), and true liver function tests (albumin, prothrombin time, partial thromboplastin time and bilirubin). If liver enzymes are elevated, a hepatitis serology panel is added. Tests to determine the cause of hepatomegaly vary, depending on the suspected cause, but may include: Abdominal x-ray.
  • Abdominal ultrasound (may be done to confirm the condition if the doctor thinks your liver feels enlarged during a physical exam).
  • CT scan of the abdomen.
  • Liver function tests (LFTs), including blood clotting tests.
  • MRI scan of the abdomen.
Treatment: Treatment of hepatomegaly always involves treatment of the underlying condition. In most cases, this in turn involves lifestyle changes, although in the case of liver cancer the proper treatments may include chemotherapy and other treatments for cancer. Alcoholic liver disease is treated by cessation of drinking alcohol. Non-alcoholic liver disease is treated by addressing the causes of the disease, the most common of which are obesity and diabetes. Correct diagnosis of exactly what is causing the symptom of hepatomegaly is crucial in prescribing treatment. The final stages of liver disease can result in so much damage to liver function that the only way the patient can survive is with a liver transplant. This is true of end-stage cirrhosis, for example. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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