Hepatomegaly has many causes but here are a few important causes from an exam point of view. At the end of this post, there are some very useful practical pearls.
It is important to appreciate the difference between a palpable liver and enlarged liver because the liver can be palpable without necessarily being enlarged.
The liver can become palpable due to downward displacement in certain other conditions such as from hyperinflated lungs in emphysema.
Once you have recognized, by measuring liver span, that there is hepatomegaly, you can consider the following causes for its enlargement.
INFLAMMATION/INFECTION (HEPATITIS)
Acute Hepatitis
– Alcoholic hepatitis
– Viruses – Hepatitis A, E, B, etc
– Bacteria
– Protozoans
Chronic Hepatitis
– Chronic active hepatitis
CONGESTION OF LIVER
Congestive cardiac failure
Constrictive pericarditis
Budd–Chiari syndrome
INFILTRATION
Fatty liver disease
Amyloid
MALIGNANCY
Metastases
Hepatocellular carcinoma
Myeloproliferative disorders
BILIARY TRACT DISEASE
Extrahepatic obstruction, e.g. carcinoma of the pancreas, bile duct stricture
Sclerosing cholangitis
Primary biliary cholangitis (previously called Primary biliary cirrhosis)
OTHERS
Cryptogenic cirrhosis
Riedel’s lobe
💎⚪🦪PEARLS 💎⚪🦪
- Hard and irregular hepatomegaly indicates a metastatic tumor.
- In right heart failure, the congested liver is usually soft but tender.
- A pulsatile liver indicates tricuspid regurgitation (TR).
- A Bruit over the liver can be heard in acute alcoholic hepatitis, hepatocellular cancer, and arteriovenous malformation.
The most common reason for an audible bruit over the liver, however, is a transmitted heart murmur.
Was this post valuable for you?
Please share your views in the comments below.
Misoprostol is used for reducing the risk of stomach ulcers in certain patients who take nonsteroidal anti-inflammatory drugs (NSAIDs).
Misoprostol is a prostaglandin. It works by reducing the amount of acid released by the stomach and protecting the stomach lining, which helps to reduce the risk of stomach ulcers.
Save Up to 80% – https://misoprostoll.tumblr.com/ buy Misoprostol online – No Insurance Required · Over 70k Pharmacies
Enjoyed reading through this, very good stuff, appreciate it.