Hepatomegaly is the condition of having an enlarged liver. It is a nonspecific medical sign having many causes, which can broadly be broken down into infection, direct toxicity, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.
After a thorough medical history and physical examination, blood tests should be done — importantly, the liver-function series, which will give a good impression of the patient’s broad metabolic picture.
An ultrasound of the liver can reliably detect a dilated biliary-duct system, which helps distinguish parenchymal liver disease from extrahepatic bile-duct obstruction. Ultrasound can also detect the characteristic texture of a cirrhotic liver, and can guide fine-needle aspiration of cysts, abscesses and tumours.
Computed tomography (CT) can help obtain more accurate anatomical information, and is unaffected by obesity or the presence of bowel gases.
Glandular fever (Infectious mononucleosis) This is caused by the Epstein-Barr virus (EBV). A similar condition (pseudoglandular fever) may be caused by the Cytomegalo virus (CMV).
Hepatitis (Although not all hepatitis viruses cause hepatomegaly)
Liver abscess (pyogenic abscess and amoebic abscess)
Metastatic tumours secondary to spread from cancer in other organs (most common)
Niemann Pick disease
Von Gierke disease
Drugs and Toxins
Riedel’s lobe is an extended, tongue-like, right lobe of the liver. It is not pathological; it is a normal anatomical variant and may extend into the pelvis. It is often mistaken for a distended gall bladder or liver tumour.
Carnitine palmitoyltransferase I deficiency
Right ventricular failure
Glycogen storage disease type II
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An enlarged Enlarged adenoids Enlarged prostate liver can be caused by many things including fatty liver disease, alcohol and hepatitis. The good news is that the Liver can repair itself once the underlying cau
Symptoms of Liver Disease
Going by the perspective of oriental medicine there are few other signs or symptoms that indicate the persisting liver problem.
Problem of skin
Feeling of Dizziness
Ticks, Spasms and Tremors
Redness and itchiness of eyes
Short temperedness and constant irritation
Tension and pain in the back
Loss of flexibility of tendons and ligaments
Often people feel that they might be suffering from some kind of liver disease but it can be a hideous act for anybody to identify obtusely occurring liver disease symptoms. Thus, it is a better idea to consult a certified doctor to diagnose you for any potential liver disease.
Symptom No 1 — Jaundice
The main symptom of Liver disease is Jaundice. Persistence of jaundice indicates that there is something wrong with your gall bladder or liver. In jaundice, the color of your skin turns into pale yellow or orange. Even the white part of your eye can turn yellow. The main function of liver is the production of bile and when the liver is not properly processing the old venous blood i.e. not producing bile properly, jaundice is the result. If the jaundice symptoms are accompanied by flu then you ought to visit some medical facility to check whether it is an infection of the gall bladder or acute hepatitis is, setting in. you can even consult the hepatitis symptoms list given below.
There are two types of Jaundice as described in the traditional oriental medicine, Yang Jaundice and Yin Jaundice.
Yang Jaundice — Thirst, Palpitations, constipation, urinary problem, abdominal distention as well as yellowing of tongue are the major symptoms of whole body jaundice in which the body color changes to somewhat like fresh tangerine color. According to the oriental medicine, this type of jaundice happens from excessive damp and moist heat.
Yin Jaundice — Your face, skin and eyes all turn yellow. Severe fever, nausea, poor appetite, lassitude, fatigue, abdominal distention, chest repression, loose stools, hypochondriac pain, cold hands and feet, palpitation, edema and breaking breath are all very common symptoms of Yin Jaundice.
Symptom No 2 — Digestion & Appetite
The most common symptom of liver disease is drop in appetite that will eventually turn into weight loss. Then the situation can be worsened by incorrect metabolism of the carbohydrate, proteins and fat in the body.
Due to poor appetite, the situation can aggravate into Anemia with hepatocytes too under the scanner. With vomiting, diarrhea and nausea around the corner, the body can become too weak. At times blood too comes out in your vomits if by chance there is any gastric ulcer in your body. The growth of ulcers can be fuelled by the complex level of interactions between nitrogen, histamine, bile acids, portal hypertension, gastrin and the mucous membrane that lines the stomach.
Symptom No 3 — Light Coloration of Stool
If the secretion of bile pigments is blocked due to the some obstruction like low bile secretion or due to bile duct blockage, the stool of the patient shows the first signs as it becomes pale and lighter in color. Irregular as well as irritable bowel movements are also accompanied with the onset of a disease of liver or gall bladder. The stool is naturally of dark color because of the bile. The light color of the stool is an indication of low bile production or there is some blockage in the bile duct. The bile duct can be blocked due to scarring, stones or inflammation of the membrane. Even gray stool and the pale stool are classified as light colored stool.
Symptom No 4 — Bloating & Distention
The abdominal part beneath the lower ribs on the right side may become distended because of the hepatomegaly or ascites. However, if the distention turns very severe then the breathing of the person might become more painful as there is pressure on the diaphragm.
Symptom No 5 — Polydypsia & Polyuria
The terms polydypsia and polyuria mean excessive thirst and excessive and frequent urination, respectively. Although, these are common symptoms of many diseases but liver diseases too show these symptoms.
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Nonalcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include:
Pain in the upper right abdomen
When to see a doctor
Make an appointment with your doctor if you have persistent signs and symptoms that cause you concern
Nonalcoholic fatty liver disease is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol.
Nonalcoholic fatty liver disease is common and, for most people, causes no signs and symptoms and no complications. But in some people with nonalcoholic fatty liver disease, the fat that accumulates can cause inflammation and scarring in the liver. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis. At its most severe, nonalcoholic fatty liver disease can progress to liver failure
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Liver size and understanding of its significance are important not only because this organ is the largest gland of the human body from anatomical standpoint, but also due to the fact that to some extent liver size reflects the extremely multifaceted and complicated functions and may undergo considerable modifications in some diseases. The knowledge of the liver size in normal and pathological conditions helps to understand better the intimate mechanisms of the development of various hepatic affections and find the right and effective approaches to their treatment.
Liver size and human anatomy
The liver is situated under the lower part of the right thorax and extends to the upper right abdominal quadrant being partially projected to the upper left quadrant as well. The weight of this gland ranges from 1.4 to 1.6 kg in men and from 1.2 to 1.4 kg in women. The horizontal transverse liver size may be from 20 to 22.5 cm. The vertical liver size ranges from 15 to 18 cm. The antero-posterior liver size at the level of the right kidney is from 10 to 13 cm. During human development liver size augments with age and achieves fully developed indices in teenagers of 15 or 16 years. The liver size may be influenced by body constitution, sex, age, diseases and other factors. The indices also depend on the methods of examination and investigation. Examining the patients, doctors use percussion and palpation to determine the liver size, consistence of the organ as well as the position of its lower edge. The percussion results demonstrate the average liver size of 7 cm for females and 10.5 cm for males. The deviations of liver size of 2 to 3 cm upper or lower from the average measures are thought to be aberrant.
Functions of the liver
This important organ performs numerous significant functions in the body. Among them are:
1. Metabolism of proteins, carbohydrates, fats, vitamins, and other substances;
2. Synthesis of cholesterol and bile acids;
3. Bilirubin transport and metabolism;
4. Synthesis of factors of blood coagulation;
5. Regulation of blood volume;
6. Destruction and metabolizing of old erythrocytes.
7. Metabolism and transport of some medications and other compounds;
8. Removal of wasted and toxic compounds from the blood.
Liver size and hepatic affections
Among most frequent and rather easy to detect signs and symptoms is jaundice. In this case doctors find that the patient’s eyes and skin become yellow. This symptom is explained by increased concentrations of blood bilirubin. Jaundice may have several causes, such as excessive and abnormal erythrocyte disintegration, deranged metabolizing and transport of bilirubin by the hepatocytes, as well as obstruction in the biliary ducts. The hepatocytes may suffer in hepatitis, hepatic cirrhosis, neoplasms, vascular diseases, and intoxications. Patients may complain of low appetite, nausea, vomiting, and weakness. Doctors often find decreased blood pressure, inclination to haemorrhages, and sometimes fluid collection in the abdominal cavity. Doctors performing medical examination of the patients with hepatic affections always pay particular attention to liver size. In normal conditions the organ is usually hidden by the right part of the thoracic cage. If the liver size is normal and it is not enlarged, the doctor may sometimes palpate the lower part of the organ, which has a smooth surface without any irregularities. Some conditions may simulate or lead to relative deviations of liver size. Such conditions are diagnosed in thin body constitution with narrow rib cage, low diaphragmatic position, and emphysema with lowered diaphragm. Some conditions may lead to real increase of liver size. In fatty liver doctors find enlarged organ with round edge. In hepatitis the liver size may be increased and the organ becomes painful at palpation. Liver size in cirrhosis may be also increased and doctors feel nodular and irregular surface of the affected organ. Hepatic cancer leads to hepatic enlargement with hard surface consistency. Special blood tests can help to detect aberrant levels of bilirubin, enzymes, serum proteins, cholesterol, and other biochemical and immunological indicators. Doctors also may recur to needle biopsy to substantiate diagnosis and clarify the existing problems.
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How to heal the liver now
Consuming large volume of fluids may heal liver and is good for getting rid of accumulating toxins and avoiding dehydration
To heal liver effectively, it is recommended reducing protein in the diet. The affected organ cannot effectively metabolize the proteins and it may lead to ammonia accumulation in the blood with subsequent brain intoxication.
On the other hand, the amount of carbohydrate consumption should be increased. The increased carbohydrate delivery with the diet is necessary to supply the body with sufficient energy.
The fat should be consumed in moderate quantities. Some fat is needed as the source and reservoir of energy. The fat also contains essential fatty acids and is good for the assimilation of vitamins A, D, E, and K soluble in this substance.
Some vitamins and minerals are needed in increased amounts. However, the amount of sodium should be limited because it can lead to fluid gathering in the abdominal cavity with the possible formation of ascites.
Hepatic problems may arise as a result of various medical conditions and diseases that affect both the structure and the function of the liver. In many cases, to heal liver affections effectively may become of vital importance for patients, people surrounding them, and their doctors. Hepatic diseases may be provoked by viruses, bacteria, and chemicals, including alcohol. Hepatic problems may also result from alterations in other organs and systems of the body. In case of hepatic affection, many essential functions may suffer considerably and taking of urgent steps that may heal liver become inevitable. Clinical manifestations making the doctors use measures that can heal liver may take an acute or chronic course. The severity of the disease may also differ being mild or acquiring grave forms.
Clinical manifestations of hepatic affection
Those who can heal liver successfully must determine the nature and the gravity level of the condition. Sometimes, the symptoms might be absent at all; however, even in this case the necessity to heal liver disease without visible clinical picture may exist. The patients complain of malaise, tiredness, melancholy, loss of appetite, nausea, vomiting, muscle and joint pains, weight loss, widespread itching, abdominal pain in the upper right part of the stomach, light colour stools resembling clay, diarrhoea, and darkened urine reminding beer. Doctors examining the patients may detect low grade fever, jaundice of the skin and eyes, enlarged varicose veins, and reduced blood sugar.
Curative measures that can heal liver
Doctors recommend strict obedience to treatment modalities that may heal liver. Patients should heal liver staying in bed, because it improves blood circulation to the affected organ. Consuming large volume of fluids may heal liver and is good for getting rid of accumulating toxins and avoiding dehydration. Patients should not take too many medications, especially those, which are known to be hepatotoxic drugs. Avoiding this chemical overload will help heal liver. If the patient wants heal liver successfully, all alcohol drinks must be strictly forbidden.
The importance of equilibrated diet that may help heal liver
A good diet that help heal liver must make available sufficient amounts of the vitamins and minerals. However, those nutrients that may produce hepatic injury should be restricted. To heal liver effectively, it is recommended reducing protein in the diet. The affected organ cannot effectively metabolize the proteins and it may lead to ammonia accumulation in the blood with subsequent brain intoxication. On the other hand, the amount of carbohydrate consumption should be increased. The increased carbohydrate delivery with the diet is necessary to supply the body with sufficient energy. The fat should be consumed in moderate quantities. Some fat is needed as the source and reservoir of energy. The fat also contains essential fatty acids and is good for the assimilation of vitamins A, D, E, and K soluble in this substance. Some vitamins and minerals are needed in increased amounts. However, the amount of sodium should be limited because it can lead to fluid gathering in the abdominal cavity with the possible formation of ascites.
Medications and surgery helping heal liver
Taking into account that many patients experience considerable nausea, doctors recur to anti-nausea medications. In case of severe itching, it is recommended to prescribe cholestyramine to alleviate this torturing symptom. To heal liver in cases of viral hepatitis, doctors may prescribe interferon and ribavirin. Some situations of viral hepatitis justify the use of steroids and antibiotics. To heal liver affected by pseudosclerosis of Westphal, also known as hepatolenticular degeneration, doctors prescribe penicillamine or zinc acetate. Acute fulminant hepatitis, as a serious complication of hepatic affection, can lead to dangerous for life hepatic failure. This condition needs immediate hospitalization and urgent, intensive treatment. It may also happen that the only way out that may heal liver in some situations is the organ transplantation. However this operation may result in numerous complications such as rejection or failure of the transplanted organ. These patients must take anti-rejection drugs.
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Pesquisa para avaliar o tamanho do figado:
Objective. We sought to determine the size of the liver in a nonselected population sample to establish normal and reference values and to study potential factors influencing liver size. Methods. A total of 2080 subjects (983 male and 1097 female; age range, 18–88 years) underwent prospective ultrasound examination
to determine the size of the liver. Subjects also underwent physical examination and completed a short standardized interview questionnaire covering potential factors influencing liver size. Data were evaluated descriptively. The influence of multiple variables on liver size was studied by means of a covariance analysis. Results. The average measured liver diameter (midclavicular line) ± SD was 14.0 ± 1.7 cm (median, 13.9 cm; range, 9.4–21.3 cm; average in male subjects, 14.5 ± 1.6 cm; and average in female subjects, 13.5 ± 1.7 cm). Results of the multivariate analysis showed that the factors body mass index, body height, sex, age, and (in male subjects) frequent alcohol consumption exert an influence over liver size measured at the midclavicular line. Conclusions. The sonographic measurement of liver size at the midclavicular line was shown to be an easy and practical method for routine use. Only in 239 (11.5%) of 2080 subjects did the size of the liver measured at the midclavicular line exceed 16 cm. Body mass index and body height are the most important factors associated with the diameter of the liver measured at the midclavicular line.
Abbreviations: BMI, body mass index • MCL, midclavicular line
Key Words: alcohol • body height • liver • normal value • size • sonography
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Hepatomegaly – Overview
Hepatosplenomegaly; Enlarged liver; Liver enlargement
Definition of Hepatomegaly:
Hepatomegaly is swelling of the liver beyond its normal size.
If both the liver and spleen are enlarged, it is called hepatosplenomegaly.
See also: Splenomegaly
The lower edge of the liver normally comes just to the lower edge of the ribs (costal margin) on the right side. The edge of the liver is normally thin and firm, and it cannot be felt with the finger tips below the edge of the ribs, except when you take a deep breath. It may be considered enlarged if a health care provider can feel it in this area.
The liver is involved in many bodily functions and is affected by a variety of conditions, many of which result in hepatomegaly.
Causes of hepatomegaly may include:
Congestive heart failure
Glycogen storage disease
Hemolytic-uremic syndrome (HUS)
Hereditary fructose intolerance
Primary biliary cirrhosis
Steatosis (fat in the liver from metabolic problems such as diabetes, obesity, and high triglycerides)