...
Is there jaundice? Hepatomegaly with jaundice may make one think of hemolytic anemias; toxic or infectious hepatitis; bile duct obstruction due to stones, carcinoma of the pancreas, or ampulla of Vater; and biliary cirrhosis.
Is ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Is the jaundice associated with hepatomegaly? There is little or no hepatomegaly associated with hemolytic anemias, pernicious anemia, Gilbert's disease, and Dubin-Johnson syndrome.
Is the hepatomegaly massive? Massive ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Hepatomegaly, or enlargement of the liver, usually refers to a liver span of larger than 12 cm at the right midclavicular line or a palpable left lobe in the epigastrium. However, liver size on physical exam is only an approximation and should be accurately measured... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Yellow skin pigmentation caused by elevated serum bilirubin level is termed jaundice. Bilirubin is the major breakdown product of hemoglobin that is released from dying or damaged erythrocytes. The normal serum bilirubin is less than 1 mg/dL,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Hepatomegaly represents the clinical appearance of liver enlargement and can occur via five mechanisms, including inflammation, excessive storage, infiltration, congestion, and obstruction. The presence of a palpable liver does not always represent... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Jaundice refers to the presence of a yellow hue of the skin, sclerae, or mucous membranes. Direct, or more specifically, conjugated hyperbilirubinemia represents a pathologic condition of cholestasis. It is defined as a direct bilirubin fraction greater than 2 mg/dL, or... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Jaundice is the presence of a yellow hue of the skin, sclerae, or mucous membranes due to elevation of serum bilirubin; it usually becomes apparent at a total serum bilirubin level of 5 mg/dL. It is present in approximately 60% of term infants and 80% of premature infants... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
... Two key words to think of here are histology and obstruction. The analysis of the differential diagnosis of hepatomegaly is best begun with a histologic breakdown of the liver tissue ( Table 37 ). Thus, there are parenchymal cells
... READ EXCERPTS »
... Jaundice is not to be confused with xanthochromia, in which the skin turns orange from carotene deposits but the sclerae remain normal in appearance. Carotenemia is often seen in hypothyroidism and diabetes mellitus, but jaundice is not usually a complication of these two conditions.
... READ EXCERPTS »
... Hepatomegaly, an enlarged liver, indicates potentially reversible primary or secondary liver disease This sign may stem from diverse pathophysiologic mechanisms, including dilated hepatic sinusoids (in heart failure), persistently high venous pressure leading to... History and physical examination ... Medical causes ... Special considerations ... Pictures
... READ EXCERPTS »
...Icterus
A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. In fair-skinned patients, it’s most noticeable on the face, trunk, and sclera; in dark... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Palpable Liver without Hepatic Pathology
Normal variant
Thin or flaccid abdominal wall
Depressed right diaphragm (e.g., emphysema)
Subdiaphragmatic lesion (e.g., abscess)
... READ EXCERPTS »
... Primarily Unconjugated Hyperbilirubinemia
Increased production
Hemolysis, intravascular or extravascular
Ineffective erythropoiesis
... READ EXCERPTS »
... Primary malignant bone tumors (also called sarcomas of the bone and bone cancer) are rare, constituting less than 1% of all malignant tumors. Most bone tumors are secondary, caused by seeding from a primary site. Primary malignant bone tumors are... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Hypothyroidism, a state of low serum thyroid hormone, results from hypothalamic, pituitary, or thyroid insufficiency. The disorder can progress to life-threatening myxedema coma.
Causes and incidence
Hypothyroidism results from... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Liver cancer, also known as primary and metastatic hepatic carcinoma, is a rare form of cancer in the United States, with a high mortality. Most primary liver tumors (90%) originate in the parenchymal cells and are hepatomas (hepatocellular carcinoma,... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Hepatomegaly, an enlarged liver, indicates potentially reversible primary or secondary liver disease. This sign may stem from diverse pathophysiologic mechanisms, including dilated hepatic sinusoids (in heart failure), persistently high venous... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. In fair-skinned patients, it’s most noticeable on the face, trunk, and sclera; in dark-skinned... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Darryl G. White and Bruce A. Leibert
Approach Hepatomegaly is a physical sign noted on abdominal examination that is present in hepatobiliary disease but is not specific or sensitive to one cause. Defining... History ... Physical examination ... Testing ... Diagnostic assessment ... Summary ... Pictures
... READ EXCERPTS »
... James M. Brian and Cara K. Fox
The hepatobiliary system removes bilirubin, a byproduct of hemoglobin metabolism, from the blood stream. Jaundice, a yellowing of the skin and sclera, results from tissue build-up of... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
... READ EXCERPTS »
... Differential Overview
❑ Acute hepatitis
❑ Chronic hepatitis
❑ Cirrhosis
❑ Right heart failure
❑... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Differential Overview
Conjugated
❑ Viral hepatitis
❑ Gallstone obstruction
❑ Drugs
❑ Carotinemia
&... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... A rare type of bone cancer, primary malignant bone tumors (sarcomas of the bone) constitute less than 1% of all malignant tumors. Most malignant bone tumors are secondary, caused by seeding from a primary site. Primary malignant bone tumors are... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Hypothyroidism, a state of low serum thyroid hormone, results from hypothalamic, pituitary, or thyroid insufficiency. The disorder can progress to life-threatening myxedema coma. Hypothyroidism is more prevalent in women than in men; in the United States, incidence is rising... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... A rare form of cancer, liver cancer (primary and metastatic hepatic carcinoma) has a high mortality. It’s responsible for roughly 2% of all cancers in the United States and for 10% to 50% in Africa and parts of Asia. Liver cancer is most prevalent in men (particularly in those... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Hepatomegaly (an enlarged liver) indicates potentially reversible primary or secondary liver disease. This sign may stem from diverse pathophysiologic mechanisms, including dilated hepatic sinusoids (in heart failure), persistently high venous pressure leading to... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A yellow discoloration of the skin, mucous membranes, or sclerae of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. Also known as icterus, jaundice is most apparent in natural sunlight. In fact, it may be... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Liver sizemay be estimated by degree of extension of liver edge below costalmargin or by span of liver dullness to percussion. In children liver edge may be normallypalpable up to 2 cm below right costal margin. However, this... Principal Causes of Hepatomegaly ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
... Jaundice,yellow discoloration of skin and sclera, is produced by depositionof bilirubin in these tissues. Increase in unconjugated or conjugatedbilirubin or both produce jaundice, which is visible when totalserum bilirubin is >2 mg/dL. Conjugated... Principal Causes of Unconjugated Hyperbilirubinemia ... Clinical Features and Diagnosis: Unconjugated Hyperbilirubinemia(Neonatal Onset) ... Clinical Features and Diagnosis: Unconjugated Hyperbilirubinemia(Postneonatal Onset) ... Diagnostic Approach: Unconjugated Hyperbilirubinemia ... Principal Causes of Conjugated Hyperbilirubinemia (NeonatalOnset) ... Clinical Features and Diagnosis: Conjugated Hyperbilirubinemia(Neonatal Onset) ... Principal Causes of Conjugated Hyperbilirubinemia (PostneonatalOnset) ... Clinical Features and Diagnosis: Conjugated Hyperbilirubinemia(Postneonatal Onset) ... Diagnostic Approach: Conjugated Hyperbilirubinemia ... References
... READ EXCERPTS »
... Hepatomegaly, an enlarged liver, indicates potentially reversible primary or secondary liver disease. This sign may stem from diverse pathophysiologic mechanisms, including dilated hepatic sinusoids (in heart failure), persistently high venous pressure leading to liver... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood. In fair-skinned patients, it's most noticeable on the face, trunk, and sclera; in dark-skinned... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
Two key words to think of here are histology and
obstruction. The analysis of the differential diagnosis of hepatomegaly is
best begun with a histologic breakdown of the liver tissue (Table
37). Thus, there are parenchymal cells... Pictures
... READ EXCERPTS »
...
Jaundice is not to be confused with xanthochromia, in which the skin
turns orange from carotene deposits but the sclerae remain normal in
appearance. Carotenemia is often seen in hypothyroidism and diabetes
mellitus, but jaundice is not usually a complication of... Pictures
... READ EXCERPTS »
... Author:
Brian Kit, MD
What to Do - Gather Appropriate Data
Scope of the Problem. According to the Centers for Disease Control and
Prevention (CDC), the prevalence of obese children in the United Sates
tripled to 16% from 1980 to 2002... Definitions ... Health Supervision for Overweight
and Obese Children ... Conclusion ... Suggested Readings
... READ EXCERPTS »
Hepatitis B is a viral infection of the liver often spread through sexual contact. But people are usually unaware they carry the virus. Find out if...
Many people with viral hepatitis don't know they are infected. Listen as experts discuss who should be tested and review the causes, prevention...
As adults, we all comprehend the fact that our parents will die eventually. But the reality of that event often has much more emotional impact than...