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Hepatomegaly

This document discusses hepatomegaly (enlarged liver). It lists various potential causes including viral and bacterial infections, autoimmune conditions, alcohol abuse, tumors, blood disorders, drug reactions, and metabolic and biliary diseases. The history taken for hepatomegaly may include presenting symptoms, past medical history, medications, family history, and social factors. The physical exam may reveal signs of liver disease or specific findings related to the cause. Initial investigations include blood tests, ultrasound, and further tests depending on suspected etiology. The most common causes of hepatomegaly in the UK are alcoholic liver disease, cancer metastases, and congestive cardiac failure.

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Fuyumi Ria
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286 views2 pages

Hepatomegaly

This document discusses hepatomegaly (enlarged liver). It lists various potential causes including viral and bacterial infections, autoimmune conditions, alcohol abuse, tumors, blood disorders, drug reactions, and metabolic and biliary diseases. The history taken for hepatomegaly may include presenting symptoms, past medical history, medications, family history, and social factors. The physical exam may reveal signs of liver disease or specific findings related to the cause. Initial investigations include blood tests, ultrasound, and further tests depending on suspected etiology. The most common causes of hepatomegaly in the UK are alcoholic liver disease, cancer metastases, and congestive cardiac failure.

Uploaded by

Fuyumi Ria
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Presentation - Hepatomegaly

Causes of hepatomegaly
 Hepatitis
o Infections
 Viral hepatitis (acute and chronic)
 EBV and CMV
 Malaria
 Abscesses – Amoebic or Pyogenic
 Autoimmune hepatitis
 Alcoholic liver disease
 Non-alcoholic fatty liver disease (previously known as NASH)
 Tumours
o Metastases
o Hepatocellular carcinoma (HCC)
o Hepatoma
 Haematological Disorders
o Leukaemia (CML and CLL)
o Lymphoma
o Haemolytic anaemias
 Thalassaemia; red cell defects; sickle cell anaemia
 Infiltration
o Amyloidosis
o Sarcoidosis
 Drugs
o Statins
o Amiodarone
o Macrolides
 Metabolic
o Haemochromatosis
o Wilson’s disease
o Glycogen storage disorders
o Porphyria
 Biliary Disease
o Extra-hepatic obstruction
 Pancreatic cancer; cholangiocarcinoma
o Primary Biliary Cirrhosis
o Primary Sclerosing Cholangitis
 Congestive
o Right ventricular failure
o Congestive cardiac failure
o Constrictive pericarditis
 Budd-Chiari

History in hepatomegaly
 Presenting complaint – very varied and depends on cause
o Abdominal distension
o Nausea
o Pruritus
o Weight loss
o Pyrexia
o Pale stool/dark urine
o Change in bowel habit
 Past medical history
o Autoimmune disease
o Inflammatory bowel disease
 Medications
o Statins
o Amiodarone
o Antibiotic use
 Family history
o Malignancy
o Chronic liver disease
o Sickle cell disease
o Autoimmune disease
 Social history
o Travel history
o Alcohol consumption
o Tattoos; blood transfusions; risky sexual behaviour

Examination of hepatomegaly
 Signs of chronic liver disease (see chronic liver disease section)
 Hepatomegaly – smooth/tender/craggy
 Cachexia
 Abdominal scars
 Lymphadenopathy

Initial investigations of hepatomegaly


 Blood tests:
o Full blood count
o Urea and electrolytes
o Liver function tests
o Clotting
o Inflammatory markers
o Blood film
o Full liver screen (see chronic liver disease section)
 Ultrasound abdomen

Further investigations and management of hepatomegaly


 Depends on cause (see other gastroenterology pages)

Common questions concerning hepatomegaly?


 What are the commonest causes of hepatomegaly in the UK?
o Alcoholic liver disease
o Cancer (metastases are the commonest or HCC)
o Congestive cardiac failure

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