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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 ... DIAGNOSTIC WORKUP
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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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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
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... 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 that can be involved
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... 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 ... Special considerations ... Pictures
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... 1. Feldman M, Scharschmidt BF, Sleisenger MH (eds): Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 6/e. Philadelphia: WB Saunders, 1997.
2. Haubrich WS, Schaffner F, Berk JE (eds): Bockus Gastroenterology, 5/e. Philadelphia: WB
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... Palpable Liver without Hepatic Pathology
Normal variant
Thin or flaccid abdominal wall
Depressed right diaphragm (e.g., emphysema)
Subdiaphragmatic lesion (e.g., abscess)
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... Reye’s syndrome is an acute illness affecting children and, less commonly, adults. It causes fatty infiltration of the liver with concurrent hyperammonemia, encephalopathy, and increased intracranial pressure (ICP). In addition, fatty... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Viral hepatitis is a fairly common systemic disease, marked by hepatic cell destruction, necrosis, and autolysis, leading to anorexia, jaundice, and hepatomegaly. In most patients, hepatic cells eventually regenerate with little or no residual damage.... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Nonviral inflammation of the liver (toxic or drug-induced hepatitis) is a form of hepatitis that usually results from exposure to certain chemicals or drugs. Most patients recover from this illness, although a few develop fulminating hepatitis... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Hepatic encephalopathy, also known as portosystemic encephalopathy or hepatic coma, is a neurologic syndrome that develops as a complication of chronic liver disease. Most common in patients with cirrhosis, this syndrome is due primarily to ammonia... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Fatty liver, also known as steatosis, is a common clinical finding consisting of accumulated triglycerides and other fats in liver cells. In severe fatty liver, fat comprises as much as 40% of the liver’s weight (as opposed to 5% in a normal liver), and the weight of the liver... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... 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 ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Susan C. Cullom
Viral hepatitis is the most common cause of liver disease in the world. In the United States, more than 300,000 cases of acute viral hepatitis occur annually. Hepatitis B and C give rise to chronic... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... 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 hepatomegaly can be... History ... Physical examination ... Testing ... Diagnostic assessment ... Summary ... Pictures
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... Differential Overview
❑ Acute hepatitis
❑ Chronic hepatitis
❑ Cirrhosis
❑ Right heart failure
❑ Fatty liver
&... Diagnostic Approach ... Clinical Findings ... Pictures
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... An acute childhood illness, Reye’s syndrome causes fatty infiltration of the liver with concurrent hyperammonemia, encephalopathy, and increased intracranial pressure (ICP). In addition, fatty infiltration of the kidneys, brain, and myocardium may occur. ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... A fairly common systemic disease, viral hepatitis is marked by hepatocellular destruction, necrosis, and autolysis, leading to anorexia, jaundice, and hepatomegaly. In most patients, hepatic cells eventually regenerate with little or no residual damage. Advanced age and serious underlying... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Classified as toxic or drug-induced (idiosyncratic) hepatitis, nonviral hepatitis is an inflammation of the liver. Most patients recover from this illness, although a few develop fulminating hepatitis or cirrhosis.
Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Also known as hepatic coma, hepatic encephalopathy is a neurologic syndrome that results from the liver’s failure to detoxify noxious agents that arise from the GI tract. Most common in patients with cirrhosis, this syndrome is caused primarily by ammonia... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Steatosis, or fatty liver, is the accumulation of triglycerides and other fats in liver cells. In severe fatty liver, fat constitutes as much as 40% of the liver’s weight (as opposed to 5% in a normal liver); the liver’s weight may increase... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... 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 ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... 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 assessmentof liver size may be... Principal Causes of Hepatomegaly ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... 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
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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 that can be involved ... Pictures
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... John Y. Tung, MB, BCh, MRCPIVani V. Gopalareddy, MD Chronic Hepatitis - BASICS Chronic Hepatitis - description Chronic active hepatitis is a continuing inflammation of the liver that may lead to cirrhosis. ... Chronic Hepatitis - DIAGNOSIS ... Chronic Hepatitis - TREATMENT ... Chronic Hepatitis - FOLLOW UP ... Chronic Hepatitis - bibliography ... Chronic Hepatitis - CODES ... Chronic Hepatitis - FAQ
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... John M. Good, MD Hepatomegaly - BASICS Hepatomegaly - description Liver enlargement beyond age-adjusted normal values; can be a common component of many diverse disease processes seen in infants and children ... Hepatomegaly - DIAGNOSIS ... Hepatomegaly - bibliography ... Hepatomegaly - CODES ... Hepatomegaly - FAQ
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... Andrew E. Mulberg, MDSeth L. Ness, MD, PhD Reye Syndrome - BASICS Reye Syndrome - description Acute encephalopathy and fatty degeneration of the liver The US Centers for Disease Control and Prevention description ... Reye Syndrome - DIAGNOSIS ... Reye Syndrome - TREATMENT ... Reye Syndrome - FOLLOW UP ... Reye Syndrome - bibliography ... Reye Syndrome - CODES ... Reye Syndrome - FAQ
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Basic Considerations
Although there are many causes of hepatitis in childhood, including toxins and
metabolic processes, the most common cause is viral infection. The purpose of
this chapter is to review the common viruses that cause hepatitis in childhood
and... Hepatitis A ... Hepatitis B ... Hepatitis C ... Epstein-Barr Virus ... Cytomegalovirus ... Selected Readings ... Pictures
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Liver transplants are the last source of hope for many patients with advanced liver disease. But not all patients are eligible for transplants, and...
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...
Organ transplants have always represented the cutting edge of medicine. And where ten years ago we worried about the procedure itself, today we worry...