Hepatomegaly: Difference between revisions
(Text replacement - "* " to "*") |
ClaireLewis (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
* | *Big liver | ||
*Caused by infection, tumours, metabolic disorders, drugs | *Caused by infection, tumours, metabolic disorders, drugs | ||
==Clinical Features== | ==Clinical Features== | ||
*Palpable (or radiologically appreciated) enlarged liver | |||
*+/- stigmata of hepatic dysfunction | |||
*+/- signs of causative pathology | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 8: | Line 12: | ||
*[[Hepatitis]] | *[[Hepatitis]] | ||
*[[Malaria]] | *[[Malaria]] | ||
* | *[[HIV]] (present in 50% of AIDS patients)<ref>Tintanelli's</ref> | ||
*[[EBV]] | |||
*[[Babesiosis]], [[leptospirosis]] | |||
*[[Typhoid]] | |||
*[[Hepatic abscess]], [[amebiasis]] | |||
'''Neoplastic''' | '''Neoplastic''' | ||
* | *Metastases | ||
*[[Hepatocellular carcinoma]] | *[[Hepatocellular carcinoma]] | ||
*[[Multiple myeloma]] | *[[Multiple myeloma]] | ||
| Line 20: | Line 28: | ||
*[[Wilson's disease]] | *[[Wilson's disease]] | ||
*[[Non-alcoholic steatohepatitis]] | *[[Non-alcoholic steatohepatitis]] | ||
*[[Inborn errors of metabolism]] | |||
'''Biliary''' | '''Biliary''' | ||
*Biliary cirrhosis | *Biliary cirrhosis | ||
'''Drugs''' | '''Drugs''' | ||
*[[ | *Alcoholic [[cirrhosis]] | ||
*[[Alcoholic hepatitis]] | |||
*[[Hepatotoxicity|Hepatotoxic drugs]] | |||
''Miscellaneous'' | |||
*Veno-occlusive disease | |||
*[[CHF]] (right heart failure) | |||
==Evaluation== | ==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 toxicity|Acetaminophen]] levels, tox panel | |||
**[[CHF]] workup if suspect right heart failure | |||
**GI consult | |||
==Management== | ==Management== | ||
*Treat underlying condition | |||
*Treat [[hepatic dysfunction]], if present | |||
==Disposition== | ==Disposition== | ||
*Dependant on presentation; consider GI follow up if discharging and hepatomegaly not previously noted | |||
=See Also== | |||
==External Links== | ==External Links== | ||
Revision as of 23:35, 26 January 2019
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
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
- 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