Hepatomegaly: Difference between revisions
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==Background== | ==Background== | ||
[[File:Sobo 1906 389.png|thumb|Inferior view of the liver with surface showing lobes and impressions.]] | [[File:Sobo 1906 389.png|thumb|Inferior view of the liver with surface showing lobes and impressions.]] | ||
*Big liver | *Big liver | ||
*Caused by infection, tumours, metabolic disorders, drugs | *Caused by infection, tumours, metabolic disorders, drugs | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC3830333 IJEM-17-283-g003.png|thumb|Hepatomegdaly palpable on exam in a pediatric patient.]] | [[File:PMC3830333 IJEM-17-283-g003.png|thumb|Hepatomegdaly palpable on exam in a pediatric patient.]] | ||
[[File:Hepatomegaly4.jpg|thumb|Hepatogedaly on exam in an adult patient.]] | [[File:Hepatomegaly4.jpg|thumb|Hepatogedaly on exam in an adult patient.]] | ||
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*+/- stigmata of hepatic dysfunction | *+/- stigmata of hepatic dysfunction | ||
*+/- signs of causative pathology | *+/- signs of causative pathology | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Hepatomegaly DDX}} | {{Hepatomegaly DDX}} | ||
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==Evaluation== | ==Evaluation== | ||
[[File:Liver measurements on ultrasonography.jpg|thumb|Evaluating liver size on ultrasound.]] | [[File:Liver measurements on ultrasonography.jpg|thumb|Evaluating liver size on ultrasound.]] | ||
[[File:Liver size at the midclavicular line at 0 to 7 years.png|thumb|Pediatric liver size percentiles.]] | [[File:Liver size at the midclavicular line at 0 to 7 years.png|thumb|Pediatric liver size percentiles.]] | ||
[[File:Se000.jpg|thumb||Hepatomegaly on CT.]] | [[File:Se000.jpg|thumb||Hepatomegaly on CT.]] | ||
*Evaluate for etiology; depending on presentation, workup may include: | *Evaluate for etiology; depending on presentation, workup may include: | ||
**[[LFTs]], coags | **[[Special:MyLanguage/LFTs|LFTs]], coags | ||
**CBC, BMP | **CBC, BMP | ||
**[[RUQ US]] | **[[Special:MyLanguage/RUQ US|RUQ US]] | ||
**[[Acute hepatitis]] serologies, other infectious workup as indicated | **[[Special:MyLanguage/Acute hepatitis|Acute hepatitis]] serologies, other infectious workup as indicated | ||
**[[Acetaminophen toxicity|Acetaminophen]] levels, tox panel | **[[Special:MyLanguage/Acetaminophen toxicity|Acetaminophen]] levels, tox panel | ||
**[[CHF]] workup if suspect right heart failure | **[[Special:MyLanguage/CHF|CHF]] workup if suspect right heart failure | ||
**GI consult | **GI consult | ||
==Management== | ==Management== | ||
*Treat underlying condition | *Treat underlying condition | ||
*Treat [[hepatic dysfunction]], if present | *Treat [[Special:MyLanguage/hepatic dysfunction|hepatic dysfunction]], if present | ||
==Disposition== | ==Disposition== | ||
*Dependant on presentation; consider GI follow up if discharging and hepatomegaly not previously noted | *Dependant on presentation; consider GI follow up if discharging and hepatomegaly not previously noted | ||
==See Also== | ==See Also== | ||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
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Latest revision as of 23:02, 4 January 2026
Background
- Big liver
- Caused by infection, tumours, metabolic disorders, drugs
Clinical Features
- Palpable (or radiologically appreciated) enlarged liver
- +/- stigmata of hepatic dysfunction
- +/- signs of causative pathology
Differential Diagnosis
Hepatic Dysfunction
Infectious
- Hepatitis
- Malaria
- HIV (present in 50% of AIDS patients)[1]
- EBV
- Babesiosis, leptospirosis
- Typhoid
- Hepatic abscess, amebiasis
Neoplastic
Metabolic
Biliary
- Biliary cirrhosis
Drugs
- Alcoholic cirrhosis
- Alcoholic hepatitis
- Hepatotoxic drugs
Miscellaneous
- Other causes of cirrhosis
- Autoimmune hepatitis
- Veno-occlusive disease
- CHF (right heart failure)
Evaluation
- Evaluate for etiology; depending on presentation, workup may include:
- LFTs, coags
- CBC, BMP
- RUQ US
- Acute hepatitis serologies, other infectious workup as indicated
- Acetaminophen levels, tox panel
- CHF workup if suspect right heart failure
- GI consult
Management
- Treat underlying condition
- Treat hepatic dysfunction, if present
Disposition
- Dependant on presentation; consider GI follow up if discharging and hepatomegaly not previously noted
See Also
External Links
References
- ↑ Tintanelli's