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Hepatomegaly in children
Last reviewed: 23.04.2024
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If a child feels a slight or severe increase in the size of the liver when feeling, then talk about a condition like hepatomegaly. Hepatomegaly in children can be physiological and pathological, moderate and diffuse. What this means, and when the child needs help, let's talk about this material.
Causes of hepatomegaly in children
In childhood, approximately five to seven years, hepatomegaly can be physiological. This symptom passes by itself, without any treatment. In older children, the physiological character of hepatomegaly is excluded: it is necessary to search for the causes of this condition.
What are the most common reasons:
- inflammatory processes (hepatitis of different species, infectious diseases, liver intoxication, including medicamentous, hepatic parasites, overlapping of bile ducts, liver abscess);
- disturbances in metabolic processes (mucopolysaccharide disorders, failure in glycogen metabolism, disruption of protein and fat metabolism, and exchange of copper or porphyrin);
- bleeding disorders (hepato-cerebral dystrophy of Wilson-Konovalov, cirrhosis, venous spasm or thromboembolism, intoxication with vinyl chloride, bile duct anomalies, lack of cardiac activity, myelofibrosis);
- liver infiltration (leukemia, hemolytic jaundice, hepatic metastases, lymphangioma, primary liver tumors, extramedullary type of hematopoietic system, histiocytosis, hemochromatosis);
- damage to the liver tissue (biliary cirrhosis, liver cysts, fibrosis, hereditary telangiectasia);
- proliferation of coastal Kupffer cells (with sepsis, excess vitamin A in the body, with granulomatous liver damage).
Also, hepatomegaly may be false, for example, due to respiratory diseases (emphysema).
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Symptoms of hepatomegaly in children
Hepatomegaly in children, in addition to increasing the size of the liver, can be accompanied by the following symptoms:
- yellowing of cutaneous and mucous membranes;
- the appearance of telangiectasias (capillary asterisks) on the abdomen;
- a painful sensation and a feeling of raspiraniya in the right hypochondrium;
- loss of appetite;
- the appearance of a bitter taste in the mouth;
- dyspeptic disorders;
- a feeling of apathy, fatigue;
- malfunctions in the blood coagulation system.
Sometimes there is an unpleasant odor from the mouth. If the disease lasts for a long time, ascites may occur - the accumulation of fluid in the abdominal cavity: while the abdomen increases in size, becomes round and dense.
In normal condition, the baby's liver should not protrude beyond the lower right rib. If the organ leaves more than 2 cm, then this condition is already defined as hepatomegaly. As we said above, the increase in the liver in a child of five to seven years can be physiological: most often this increase is of a moderate nature, that is, the increase is observed 1-2 cm from the edge of the rib.
Mild hepatomegaly in a child is a medical term that is used by specialists to distinguish between the description of pathological values and the rates of the norm. That is, if we talk about moderate hepatomegaly, we mean that the liver is enlarged, but it is not as pronounced as it would be in the most likely diseases. This condition can be observed after the introduction of vaccines, or due to a violation of the child's diet.
The opposite concept of mild hepatomegaly is a diffuse enlargement of the liver, that is, an obvious. Often diffuse hepatomegaly is associated with acute inflammatory or dystrophic processes in the organ.
Where does it hurt?
Diagnosis of hepatomegaly in children
Often, a general examination with a palpation of the organ in the right hypochondrium may be sufficient to diagnose hepatomegaly in children. Recall that hepatomegaly is not a disease - it's just a symptom, a sign of another disease that should be detected and treated.
The doctor must carefully examine the child, pay attention to the discoloration of the skin, the condition of the abdomen. There is a feeling of the area of the liver, abdominal cavity.
The severity of hepatic dysfunction can be determined by the results of blood biochemistry, blood coagulation and other hepatic assays.
In some cases, consult specialists: gastroenterologist, hematologist, infectious disease specialist.
The most common and informative method of diagnosis is ultrasound research. Such a method will help a specialist to establish a correct diagnosis even with a moderate increase in the liver in the absence of significant additional symptoms. On ultrasound the doctor can see echosprintsa violations of the tissue structure of the liver, the appearance of uncharacteristic formations and elements.
Auxiliary diagnostic methods that allow to detect the underlying disease are:
- an immunogram;
- analyzes for helminths and parasites;
- oncomarker;
- X-ray examination, etc.
What do need to examine?
Treatment of hepatomegaly in children
Treatment of hepatomegaly in children should be comprehensive: it is carried out only under the supervision of a specialist. It must be remembered that hepatomegaly is just a symptom of another disease. For this reason, the use of a medication can be carried out only after the main pathogenetic cause of liver enlargement is discovered. The medicines prescribed by the doctor must act on the original cause and stop the painful process in the body.
For example, if an infectious or viral disease is detected, antibacterial or antiviral therapy is performed, and in case of metabolic disorders, restorative or substitution therapy is performed. With cirrhosis appoint drugs that support the function of the liver, making up for the lack of enzyme substances released by it.
Also, hepatoprotective therapy may be prescribed, providing for the creation of additional protection for the liver. Medicinal preparations Essentiale, karsil, heptral and others are used.
In addition, the treatment of hepatomegaly requires the appointment of special dietary nutrition. The purpose of such a diet is to facilitate the work of the liver, to reduce the burden on the organ. The emphasis in nutrition is on vegetable and balanced food, with a decrease in the intake of foods rich in fats and carbohydrates. Especially relevant diet for hepatomegaly, caused by a violation of metabolic processes.
Prevention of hepatomegaly in children
An important element of the prevention of hepatomegaly in children is the child's compliance with the regime of food intake, rest, and timely treatment of diseases of the body.
It is necessary to avoid excessive physical exertion, especially after infectious and inflammatory diseases. Often after a hepatitis or a cholecystitis the child can note an intensification of painful sensations after physical exercises, driving in transport, fast walking or running.
Children should be strengthened immunity, avoid hypothermia and colds. Many infectious diseases (herpes, acute respiratory infections, etc.) can cause inflammatory diseases of the biliary system. For the same reason, dental caries should be treated in a timely manner, since bacteria from there can be transported with blood to almost any organ.
It is also necessary to combat helminthic invasions: parasites from the intestine can enter the gallbladder and bile canals, which can provoke the development of the inflammatory process and even lead to obstruction of the biliary tract.
Of no little importance is the psychological state of the child. Stresses, fears, unrest can negatively affect the health of the baby, as well as lead to dyskinesia and other liver diseases.
If the doctor prescribed treatment (for infection, inflammation, etc.), it is important to follow exactly all the equipment recommended by the doctor. Self-medication is not the best option for helping a child.
Do not allow children to overeat: an excessive load on the digestive organs will sooner or later be felt by the appearance of any pathology, including liver diseases.
Watch for the full nutrition of the child, more often with him in the fresh air, ensure him a good night's rest, observe the rules of hygiene, and then your baby will be healthy and active.
Prognosis of hepatomegaly in children
The prognosis of hepatomegaly in children depends on the origin of this symptom and the presence of other signs and complications.
Hepatomegaly associated with the presence of an infectious or viral disease is curable. Special treatment, timely started and competently made, can guarantee a complete cure in more than 80% of cases.
With toxic liver damage, the prognosis is somewhat worse, but it all depends on the degree of toxins on the liver, as well as on the timeliness of the measures taken. If the pathology has developed into cirrhosis, the prognosis of the disease worsens.
Parents need to remember that timely access to a specialist, carrying out preventive examinations of the child, helps to detect hepatomegaly already in the initial stage. Therefore, do not be afraid of going to the doctor: often this can save the child not only health, but life.
If hepatomegaly in children is not physiological in nature, then it should not be treated independently: this symptom may be a sign of many diseases that should be identified and cured.