Hepatomegaly is a pathological increase in the size of the liver .
| Hepatomegaly | |
|---|---|
| ICD-10 | R16, R16.0, R16.2 |
| ICD-9 | 789.1 |
| Medlineplus | |
| Mesh | |
Hepatomegaly is characteristic of many liver diseases , in particular, for viral hepatitis , for alcoholic fatty hepatosis , etc. Also, hepatomegaly is often observed in congestive heart failure . In this case, hepatomegaly is observed as a result of stagnation of blood in the portal portal vein of the liver and blood overflow of the hepatic venous sinuses . Hepatomegaly can also occur in chronic infections, intoxications, in the neutralization of which the liver plays an important role, and in infections whose pathogens can parasitize in the liver (for example, with malaria ). Hepatomegaly also occurs in case of tumor infiltration of the liver - both in case of primary carcinoma of the liver and in metastases of malignant tumors of other organs in the liver.
Especially pronounced hepatomegaly is observed with leukemia and other hemoblastoses , as a result of massive infiltration of liver tissue by malignant leukemia or lymphoblastic cells, or as a result of the formation of foci of extra bone marrow (extramedullary) hematopoiesis in the liver. In these cases, the liver sometimes reaches a huge size, occupying more than half of the abdominal cavity and sometimes reaching a weight of about 10-20 kg.
Definition
If the size of the liver is l. medioclavicularis dextra exceeds 12 cm or the left lobe is palpated in the epigastric region , indicating an increase in the liver. It is important to exclude prolapse of the liver (for example, with chronic obstructive pulmonary disease or bloating of the right lung) or the location in the upper right quadrant of other tissues (enlarged gall bladder , swelling of the kidney or intestine). The size of the liver is best determined by CT or ultrasound . It is important to evaluate the contours and pattern of organ tissue; An increase in certain sections of tissue; "Stony" consistency suggests the presence of a tumor; palpation pain indicates inflammation ( hepatitis ) or a rapid increase in organ size (right heart failure, Budd-Chiari disease ( Budd-Chiari syndrome ), fatty infiltration ).
The Most Important Causes of Hepatomegaly
- Vascular congestion: right heart failure (including tricuspid valve disease), Budd-Chiari disease
- Infiltrative processes: accumulation of fat ( “fat” liver , for example, ethanol , diabetes , excessive parenteral nutrition , pregnancy ), lymphoma or leukemia , extramedullary hematopoiesis , amyloidosis , granulomatous hepatitis (caused by tuberculosis , atypical mycobacteria , cytomegalovirus , sarcochidosis , sarcoidosis Gaucher , glycogenosis
- Inflammatory diseases: viral or drug hepatitis , cirrhosis
- Tumors: primary carcinoma , metastatic cancer, focal nodular hyperplasia , liver adenoma
- Cysts : polycystic
- Liver disease. For example, with a deficiency of lysosomal acid lipase, hepatomegaly is observed in 87% of patients.
Literature
- Hepatomegaly . medical directory of diseases.
- Hepatomegaly . Per. from English N. D. Firsova (2018).
- Krivopustov S.P. Hepatomegaly: a problem-oriented approach in pediatrics . Kiev, 2012.