Differential diagnosis differentialdiagnosis oficterus. Other functions include filtering senescent and defective red blood cells, presenting antigens to the immune system, and destroying. Differential diagnosis of hepatosplenomegaly homeopathy. What is a presumptive and differential diagnosis for influenza. Differential diagnosis of fever with hepatomegaly download here free healthcaremagic app to ask a doctor all the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Ultrasound of the liver efsumb european course book pdf. Often, hepatomegaly will present as an abdominal mass. Progressive ascending paralysis in an adult male diagnosed with poems syndrome. A normal liver should feel soft and is easily moveable upon inspiration.
What is the differential diagnosis of hepatomegaly. Hepatomegaly and elevated aminotransferases in a patient with poorly regulated diabetes. Hepatomegaly hepatomegaly is the condition of having an enlarged liver. Hepatitis a vaccine is also recommended for most cases of postexpo sure prophylaxis, although immunoglobulin is an acceptable alterna tive in some situations. Diagnostic algorithm to arrive at the most common diagnoses for a neonate who has hepatomegaly.
Massive hepatomegalyis associated with gauchersdisease. 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. Differential diagnosis of nafld a short summary naspghan. Hepatomegaly may be found during physical examination or on imaging studies. Differentials of gross hepatomegaly include leukaemia and other reticulo. This website is available offline as an app that is searchable and editable on your phone. Differential diagnosis of fever with hepatomegaly doctor. Oct, 2008 hepatomegaly is caused by inflammation, infiltration, obstruction, storage abnormalities and vascular congestion.
Hepatic vein thrombosis, a blockage of veins in your liver. Get a printable copy pdf file of the complete article 932k, or click on a page image below to browse page by page. Hepatocellular carcinoma hcc should be considered in the differential diagnosis of any liver mass. Diagnosis, differential glycogen storage diseasediagnosis hepatomegaly humans. Pdf a 21yearold woman with hepatomegaly researchgate. Practice change upon completion of this session, you should be able to. Hepatomegaly is a symptom that can be caused by a variety of conditions that affect different organ systems.
The code is valid for the year 2020 for the submission of hipaacovered transactions. Whipple,ls rousselot19 and thompson2o among others insist that the group of cases now under discussion also represent a secondary congestive splenomegaly. Of note, the liver may be displaced downward by the diaphragm or thoracic contents leading to false impression of hepatomegaly. Dec 07, 2018 dehydration describes a state of negative fluid balance that may be caused by numerous disease entities. May 6, 2020 infections of central nervous system, bacterial meningitis. Dehydration describes a state of negative fluid balance that may be caused by numerous disease entities. Hepatomegaly is caused by inflammation, infiltration, obstruction, storage abnormalities and vascular congestion. The differential diagnosis of jaundice, or hyperbilirubinemia, is often organized pathophysiologically. Alternative diagnostic tests to percutaneous liver biopsy are available.
What links here related changes upload file special pages permanent link page information wikidata item. Hepatomegaly is enlargement of the liver beyond its normal size and occurs mainly as a consequence of pathologic conditions. Hepatomegaly is the condition of having an enlarged liver. Churchills pocketbook of differential diagnosis pdf 4th. This video describes the causes and symptoms of hepatomegaly. Splenomegaly is a feature of a broad range of diseases, and presents to clinicians in many. Hepatomegaly pediatrics clerkship the university of chicago.
Hepatomegaly, hepatomegaly, liver enlargement, liver enlargement, dhepatomegaly contextdependent category, dhepatomegaly nos contextdependent category, d. The liver may be transiently enlarged in acute alcoholic hepatitis. Hepatomegaly is enlargement of the liver beyond its normal size. It is the most common primary liver malignancy in the world this distinction excludes metastatic lesions to the liver, as metastatic colorectal cancer is the most common tumor of the liver overall. Pediatric gastrointestinal unit, massachusetts general hospital, boston, massachusetts 02114 hepatomegaly an approach to differential diagnosis w. Typical doses from radiology exams plain films dose mrem chest, 2 view 6 cspine series 27 lspine series 180 mammogram ct exams dose mrem ct head 200. Unfortunately, an enlarged liver may go unnoticed for some time. Diagnosis requires the two major criteria plus at least one minor criterion. The average liver span is 45 cm in newborns and 68 cm in children at 12 years of age.
Hepatomegaly splenomegaly hepatosplenomegaly quizlet. Maddreys discriminant function test was described by maddrey and colleagues in 1978 to predict prognosis in alcoholic hepatitis. Pdf on nov 1, 2007, d joshi and others published a case of hepatomegaly find. Sign or symptom t184 207231001, 207233003, 207232008, 158515001, 158508, 158514002, 80515008. Before liver biopsy, clinicians considered amyloidosis in the differential diagnosis for only 14 patients 26%. It is a reservoir for platelets and a site for the proliferation of blymphocytes. Hepatomegaly, hepatomegaly, liver enlargement, liver enlargement, d hepatomegaly contextdependent category, d hepatomegaly nos contextdependent category, d. There is peripheral vascular enhancement of the mass, which has a primarily necrotic center. Jaundice and abnormal liver enzymes symptom to diagnosis. Viral hepatitis differential diagnoses medscape reference.
Acute cytomegalovirus cmv infection and toxoplasmosis can share many additional characteristics with infectious mononucleosis, including splenomegaly, hepatomegaly. 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. In a study of 144 patients with nash, 18 percent were noted to have hepatomegaly on examination andor ultrasound, and there was a trend toward an increased rate of hepatomegaly among those with more advanced fibrosis 28 percent 18. Dehydration differential diagnoses medscape reference. Differential diagnosis hepatomegaly doctor answers on.
Pdf hepatomegaly and elevated aminotransferases in a. When evaluating a child with hepatomegaly it is important to identify conditions in which immediate medical intervention is needed and provide appropriate treatment options. Kupffer cell hyperplasia with tb or other generalized infections. It is a nonspecific medical sign having many causes, which can broadly be. Differential diagnosis included hepatoblastoma, hepatocellular carcinoma, and embryonal sarcoma. The splenomegaly is secondary to this diagnosis of hepatomegaly and splenomegaly latter. An ultrasound of the abdomen confirmed an enlarged liver, with no focal lesions. The differential diagnosis of hepatomegaly includes. When faced with a newborn, asking about the pregnancy, labor and delivery are especially important since these questions can elicit risk factors for the various causes of respiratory distress in the newborn. How you get treated for your enlarged liver depends on. Diagnosis, differential glycogen storage disease diagnosis hepatomegaly. Hepatomegaly causes of hepatomegaly hepatitis infections viral hepatitis acute and chronic ebv and cmv malaria abscesses amoebic or pyogenic autoimmune hepatitis alcoholic liver disease nonalcoholic fatty liver disease previously known as nash tumours metastases hepatocellular carcinoma hcc hepatoma haematological disorders leukaemia cml and cll lymphoma haemolytic anaemias.
Hepatomegaly in the absence of signs of cld is unlikely to be due to cirrhosis. Splenomegaly general presentation the spleen is a hematopoietic organ supporting the megakaryotic, lymphoid, erythroid, myeloid, and reticuloendothelial systems. The differential diagnosis of hepatomegaly and splenomegaly. Hepatosplenomegaly can occur as the result of acute viral hepatitis, infectious mononucleosis, and histoplasmosis or it can be the sign of a serious and lifethreatening lysosomal storage disease. Hepatomegaly can represent intrinsic liver disease or may be the presenting physical finding of a generalized disorder. Hepatomegaly can result from a vast range of pathology including, but not limited to, the following. Systemic venous hypertension can also increase the risk for. Hepatomegaly differential diagnosis things you didnt know. It is important to realize that the liver is easily palpated in most children at 12 cm below the right costal margin. A large lesion, measuring 12 cm in diameter, is seen in the right lobe of the liver. Venoocclusive disease, which is a blockage in the small veins in your liver. Differential diagnosis patients with streptococcal pharyngitis or one of several viral pharyngitides present with sore throat, fatigue, and adenopathy. In studies of inpatients with splenomegaly, haematological diseases were positively associated with lymphadenopathy, massive splenomegaly and cytoses erythrocytosis, leucocytosis, thrombocytosis, marked left shift of the neutrophilic leucocytes or. Hepatosplenomegaly commonly abbreviated hsm is the simultaneous enlargement of both the liver hepatomegaly and the spleen splenomegaly.
Hepatomegaly refers to an increase in size or enlargement of the liver. Is there associated fever, right upper quadrant pain, or a tender liver. Hepatomegaly enlarged liver causes, symptoms, and diagnosis. The border of the liver can be found by palpation, percussion, and auscultation. Diarrheal illnesses are the most common etiologies. The best way to assess size is by percussion a normalsized liver can appear. Hepatitis, a general term referring to inflammation of the liver, may result from various causes, both infectious ie, viral, bacterial, fungal, and parasitic organisms and noninfectious eg, alcohol, drugs, autoimmune diseases, and metabolic diseases. Churchills pocketbook of differential diagnosis is the best differential diagnosis book for medical students who are working or are looking forward to more of the clinical approach to the field. See chapter, peritoneal abdominal paracentesis for more details. Acsase medical student core curriculum intraabdominal. After ruling out the most common causes of hepatomegaly, how do you determine the underlying.
May 05, 2016 hepatomegaly is enlargement of the liver. Imaging is more accurate in determining liver size. Sep 16, 2015 hepatomegaly, also known as an enlarged liver, isnt considered a disease, but its usually a sign something is wrong with the liver. As the liver shares in fetal erythropoiesis, fetal hepatomegaly increases fetal hemoglobin level that increases liver iron content as well as protein, copper, and zinc 5. Major criteria polyneuropathy monoclonal plasma cellproliferative disorder minor criteria organomegaly splenomegaly, hepatomegaly, or lymphadenopathy endocrinopathy adrenal, thyroid, pituitary, gonadal, parathyroid, pancreatic. Jun 12, 2017 hepatitis, a general term referring to inflammation of the liver, may result from various causes, both infectious ie, viral, bacterial, fungal, and parasitic organisms and noninfectious eg, alcohol, drugs, autoimmune diseases, and metabolic diseases. Full text full text is available as a scanned copy of the original print version. This can cause hepatomegaly affecting either the whole of the liver or occasionally only he left lobe. When a person first feels symptoms, a doctor will likely do a. Inflammation autoimmune disease bile acid enzyme defects canalicular bile acid transport defects infections virus, abscess idiopathic neonatal hepatitis. Progressive ascending paralysis in an adult male diagnosed.
It is a non specific medical sign having many causes, which can broadly be broken down into infection, direct toxicity, hepatic tumours, or metabolic disorder. The lower edge of the liver normally comes just to the lower edge of the ribs costal margin on the right side and it cannot be palpated. Hepatomegaly, also known as an enlarged liver, isnt considered a disease, but its usually a sign something is wrong with the liver. Acsase medical student core curriculum intraabdominal and.
D the differential diagnosis of primary amenorrhea includes constitutional delay, eating disorders, chronic disease typically causing low weight for height, severe androgen resistance, rokitansky syndrome absence of uterus, imperforate hymen, gonadotropin deficiency, and primary ovarian failure. It is smooth, uniform, nontender and descends to meet the palpating fingers on inspiration. Use the serum albumin to ascitic albumin difference serum albumin minus ascites albumin to help differentiate the cause of ascites. There is little or no hepatomegalyassociated with hemolytic anemias, pernicious anemia, gilberts disease, and dubinjohnson syndrome. The liver edge is normally palpable in children and thin adults and some patients may have a palpable right lobe of the liver.