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Hepatomegaly of the liver: what is it, echoes, how to treat

 

Hepatomegaly is an enlargement of the liver, which acts as a sign of various diseases. Consider the main causes of hepatomegaly, types, methods of diagnosis and treatment.

The liver is an organ that decomposes metabolic products into non-toxic constituents that are excreted from the body with feces or urine. In this body, chemical reactions occur that neutralize toxic substances and poisons. The pathological enlargement of the liver is called hepatomegaly and can occur when poisoning with poisons or toxins. Scientists do not consider this pathology as an independent disease, but define it as a syndrome, which indicates an unsatisfactory state of baking and the whole organism as a whole.

Causes of the hepatomegaly

Hepatomegaly acts as a characteristic sign of liver damage, the nature and stage of which depends on the size of the organ. Pathology occurs with diseases of the cardiovascular system, tumor processes in the body or metabolic disorders. Increase, swelling and inflammation occur with cirrhosis and hepatitis. With these diseases, the connective tissue of the organ grows, and the parasitic and bacterial infection leads to an increase in its lobes. Hepatomegaly requires careful diagnosis, as it is a sign of impaired functioning of the body.

The causes of liver hepatomegaly can be conditionally divided into several groups, each of which depends on the disease that caused its increase. There are metabolic disorders, liver diseases and cardiovascular diseases. All of them cause cell damage and tissue swelling (in rare cases, the regeneration process begins). If, in inflammatory processes, the use of medications can restore the body to a normal state, then hepatomegaly leads to an active growth of connective tissues. New fabrics are formed much faster than the destruction of old ones. As a result of this, only part of the dead hepatocytes are subject to substitution, and the organ acquires a knobby form and significantly increases in size.

Consider the main causes of hepatomegaly:

  • Hepatitis A, B, C, toxic hepatitis.
  • Infectious diseases: malaria, mononucleosis.
  • Alcohol intoxication of the liver.
  • Nonalcoholic and alcoholic fatty degeneration.
  • Cancerous metastases to the liver from other organs and cysts filled with fluid.
  • Gaucher disease, that is, the accumulation of fatty substances in the liver.
  • Irreversible fibrotic changes in the body as a result of cirrhosis.
  • Biliary duct obstruction and occlusion of hepatic veins.
  • Pericarditis.
  • Leukemia.
  • Malignant tumors of the lymphatic system.
  • Benign tumors of the liver: adenoma, hemangioma
  • Accumulation of abnormal protein in the liver - amyloidosis.
  • Metabolic disorders.
  • Disease Wilson, that is, the deposition of copper in the liver.

Symptoms of the hepatomegaly

Hepatomegaly of the liver is a pathological increase in the organ and a diffuse change in its tissues. With this pathology, the liver can easily be palpated under the ribs, while a healthy organ is difficult to feel. When palpation, the patient feels pain, which is also a sign of the disease. Hepatomegaly is a symptom that indicates that the liver needs treatment.

An increase in this organ can occur due to inflammatory processes, viruses or toxins. Inflammation entails swelling of the liver and the death of some healthy cells. The disease appears and with cirrhosis, viral hepatitis or prolonged intoxication of the body (chronic alcoholism). Violations of the formation of glycogen causes the accumulation of this substance in the liver, which leads to hepatomegaly, an increase in the spleen and kidneys.

Diseases of the cardiovascular system lead to ventricular failure, causing stagnation of blood in the organs and tissues. In chronic or congenital heart failure, the liver suffers first. Hepatomegaly is provoked by oncological diseases, cancerous growths that lead to organ proliferation and disruption of its functioning.

Syndrome of hepatomegaly

The hepatomegaly syndrome indicates an increase in liver size. There are many reasons for this pathology. Very often this syndrome is accompanied by an increase in the spleen. The enlargement of the liver indicates signs of other diseases of the body. There are a number of factors that increase the risk of hepatomegaly syndrome, consider them:

  • Alcohol abuse increases the risk of liver damage, cancers and cirrhosis.
  • Higher doses of drugs, dietary supplements and vitamins cause intoxication and liver damage.
  • Many infectious diseases, for example, malaria, viral hepatitis and others.
  • Malnutrition and overweight are another factor that causes liver enlargement. Abuse of fat, sweet, spicy or salty foods is a direct way to increase the liver.

Symptoms of hepatomegaly depend on the disease that caused the enlargement of the liver and its clinical manifestations. If it is pronounced (the liver reaches a large size), then it can be found on palpation and even on the outline of the abdomen. If the organ is not enlarged, then for diagnosis it is necessary to seek medical help and undergo a series of examinations. With the help of palpation and percussion, the doctor will determine the size and degree of organ enlargement.

Consider the symptoms characteristic of hepatomegaly:

If hepatomegaly occurs against the background of hepatitis, the patient will experience a uniform increase and consolidation of the parenchyma. Because of this, the lower edge of the liver can be palpated under the costal arch. Attempts to feel the liver cause pain and discomfort. With exacerbation of hepatitis, the pain becomes permanent. Hepatitis causes jaundice of the skin and symptoms of intoxication (weakness, fever, headaches). With timely diagnosis and properly selected antiviral treatment, hepatomegaly gradually returns to normal body size.

Complication of hepatitis is cirrhosis, which is also accompanied by hepatomegaly. In this case, the increase in organ tissues is due to the destruction of hepatocytes and the formation of a scar from the connective tissue in their place. Because of multiple foci of necrosis, total replacement of healthy tissue with a connective tissue takes place. The liver increases, causes disturbances in the functioning of the body. The patient has a tendency to bleeding, an earthy skin tone and a constant throbbing pain in the right hypochondrium.

There are extrahepatic diseases, the main symptom of which is an increase in this organ. These include metabolic disorders of both hereditary and acquired character. Due to the violation of glycogen catabolism, it begins to accumulate in the liver, which leads to its slow increase. But besides the liver, the kidneys and the spleen suffer, which also increase in size.

Hepatomegaly causes hemochromatosis, an exchange disease that provokes the malfunctioning of enzyme systems responsible for the absorption and binding of glandular compounds. In this case, the increase in the organ develops according to the type of cirrhosis. But changes occur not only in the liver, but in the lungs. The patient suffers from a strong cough with red phlegm.

To provoke an increase in the liver can the diseases of the cardiovascular system. Due to lack of contractility, blood circulation stagnates, which leads to a violation of the outflow of blood from the internal organs. As a result, the liver and other organs form a prolonged puffiness, which provokes the growth of the organ. Long-term hepatomegaly can cause necrotizing hepatocytes and their replacement with connective tissue.

Hepatomegaly due to the left lobe

Hepatomegaly due to the left lobe of the liver occurs rarely. The enlargement of the organ can be caused by infectious agents or diseases of the internal organs. The left share of the liver is located very close to the pancreas, so diseases and diffuse changes in the pancreas can cause hepatomegaly due to the left lobe.

In this case, the patient is fully diagnosed by the body with a detailed study of the functioning of the organs. Cholestasis, pancreatitis and other pancreatic lesions affect not only the liver, but also the gallbladder and spleen.

Hepatomegaly of the right lobe of the liver

Hepatomegaly of the right lobe of the liver is observed quite often. The increase can have a natural character, since the right share carries a high functional load. In this case, any infectious lesions, inflammatory processes, exposure to toxins or malnutrition affect the right lobe of the organ.

But all the negative factors can cause violations in the work of the liver, which negatively affects the functioning of the whole organism. Therefore, during the examination, special attention is paid to the right lobe, as it is 60% responsible for the liver. If hepatomegaly is detected, a comprehensive treatment of the entire organ is performed.

Diffuse hepatomegaly

Diffuse hepatomegaly occurs when the liver size in an adult exceeds 12-13 cm. This organ consists of two parts - the right and left, each of which has its own blood supply, nerve fibers and bile excretion. The tissue of the lobules is formed from elongated cells, which are permeated with blood vessels and capillaries. Each share has a central vein, arteries and bile ducts. Diffuse changes, that is, hepatomegaly can affect any of the above elements.

Streptococcal, staphylococcal and other infections cause abscesses in the liver, which leads to diffuse hepatomegaly. The patient suffers from tachycardia, aching pain in the right hypochondrium, which give in the shoulder and arm, a strong chill. Treatment in this case is carried out only by a surgical method, since taking medications is not effective. If diffuse changes in the size and structure of the body are caused by cirrhosis (intoxication with alcohol or toxic substances, poisons), then hepatomegaly causes joint pain and an increase in the spleen.

Hepatomegaly with diffuse changes

Hepatomegaly with diffuse changes indicates inflammatory processes in the liver. The normal structure of the organ is uniform, there are no deformations of the tissue or any seals. Changes can cause mild abnormalities in the structure of the liver with complete preservation of the organ functions. But, as a rule, this condition is accompanied by hepatic insufficiency, increasing intoxication and frequent bleeding. Diffuse changes are a symptom of the underlying disease, which provokes abnormalities. It can be both hepatic diseases, as well as lesions of a general nature that cause metabolic disorders and inflammation.

The cause of diffuse changes in hepatomegaly may be the prolonged use of medicines or the abuse of fatty foods. Daily exposure to toxins on the body leads to a disturbance of the liver function, a change in the structure and size of the organ. Light diffuse changes can provoke even a new diet, by the way, this is a common cause of hepatomegaly in women.

To diagnose a diffuse increase in the liver, ultrasound is performed. If there is a slight increase in the organ and a uniform compaction of the parenchyma, the patient is checked for hepatitis. More details about the degree of disturbances in the work of baking the severity of liver failure are judged by the results of a biochemical blood test. If changes in body contours are detected, a tuberous and uneven structure, this may indicate cirrhosis.

The main treatment for hepatomegaly with diffuse changes is compliance with the diet. The patient is a diet that means giving up fatty, spicy and sweet foods, as well as alcohol and other bad habits. For the purification of the liver can use the methods of alternative medicine and, of course, medication. But the most important thing is to determine the cause of the pathology in a timely manner and begin immediate treatment and a comprehensive impact on the symptoms of the disease.

Partial hepatomegaly

Partial hepatomegaly is not a uniform increase in the liver, that is, a change in the size of individual parts or parts of the organ. For example, hepatomegaly of the left or right lobe of the liver, indicates a partial increase in the organ. In rare cases, there is an uneven change in the lower edge of the liver. When palpation, this pathology is felt uneven and bumpy.

Partial hepatomegaly can be diagnosed by ultrasound. The disease has a characteristic echospresign: a violation of the uniformity of the tissues of the organ. The presence of tumors, cysts or abscesses, also indicate a partial change in the liver and the progression of the disease.

Hepatomegaly and splenomegaly

Hepatomegaly and splenomegaly are two diseases that very often occur simultaneously and one of them can provoke the appearance of the second. Hepatomegaly is an enlargement of the liver, and splenomegaly is an enlargement of the spleen. There is a hepatolyenal syndrome, that is, a combination of pathologies and a change in the size of the spleen and liver.

Hepatomegaly and splenomegaly occur with such diseases of the body:

  1. Chronic liver damage (focal, diffuse), as well as diseases that cause circulatory disorders in the systems of hepatic and splenic veins.
  2. Hemochromatosis, amyloidosis, Gaucher's disease, hepato-cerebral dystrophy and other diseases.
  3. Parasitic and infectious diseases: abdominal tuberculosis, malaria, alveococcosis, infectious mononucleosis and others.
  4. Diseases of lymphoid tissue and blood: leukemia, lymphogranulomatosis, hemolytic anemia.
  5. Diseases of the cardiovascular system, accompanied by chronic circulatory failure: ischemic heart disease, heart defects, pericarditis.

Involvement in the pathological process of the spleen is explained by the close functional connection of the organs. Hepatolienal syndrome is more common in patients of childhood than in adults. This is due to the anatomical and physiological characteristics of the growing organism. Hereditary diseases, infectious diseases and congenital anomalies, can also provoke hepatomegaly and splenomegaly.

As a rule, the diagnosis is not difficult and is carried out by percussion and palpation. The main difficulty lies in determining the cause, that is, the underlying disease that caused hepatomegaly and spleen involvement.

Hepatomegaly against a background of fatty hepatosis

Hepatomegaly against a background of fatty hepatosis is an increase in the liver caused by the degeneration of the body cells into fat. Most often, this disease occurs when accumulating in the liver cells (hepatocytes) simple fats. Pathology develops due to the impact on the body of alcohol, fatty foods, medications and other negative factors. All toxic substances enter the liver, where they are neutralized and degenerated into simple fats. But since enough fat is supplied with food, its excess accumulates in the liver cells, causing slow hepatomegaly.

Over time, cells can degenerate. This suggests that left without treatment fatty hepatosis is generated in fibrosis and cirrhosis of the liver. There are several stages of the disease:

  • At the first stage, foci of cells with a high concentration of simple fats appear. If there are several lesions, they can cause diffuse changes in liver tissue.
  • In the second stage, the number of fat cells increases, and the connective tissue begins to grow between the cells.
  • At the last stage, pronounced striations of connective tissue appear, which subsequently lead to fibrosis and severe hepatomegaly.

One of the reasons for hepatomegaly against the background of fatty hepatosis is metabolic disorders and obesity. But there are other factors that can cause disease, consider them:

  • Diseases that cause lipid metabolism disorders: type 2 diabetes, obesity, hypertriglyceridemia and others.
  • Toxic effects on the liver. Due to the permanent neutralization of toxic substances, the liver ceases to fully perform its functions, which leads to its inflammation and increase. There is such a thing as alcoholic fatty hepatosis caused by the systematic use of alcohol.
  • Digestive disorders and concomitant diseases. The liver takes an active part in the process of digestion, but if there is a violation of fat absorption or excretion of bile acids, it leads to serious pathologies.
  • Diseases of the endocrine system. Fatty hepatosis occurs with excessive production of hormones of the adrenal cortex and with a deficiency of the thyroid hormone.
  • Malnutrition causes lipid impairment, which entails hepatomegaly and fatty hepatosis. Irregular meals, a limited amount of protein, regular fasting, frequent change of diets. All this leads to the exhaustion of the body and to the fact that the liver cells stop doing their work.
  • Long-term use of drugs or probiotics, as well as radiation, causes liver disease

The main symptom of hepatomegaly against the background of fatty hepatosis is nausea, vomiting, pain in the right upper quadrant. The patient appears dysbiosis, the skin condition worsens, the visual acuity may fall. Strongly expressed symptoms of the disease occur at the last stage of fatty hepatosis.

Hepatomegaly in children

Hepatomegaly in children can occur at any age, as in newborns, and in adolescents or school-age children. The incidence of hepatomegaly in children is carefully studied by pediatricians. Dysfunction of the diet, autoimmune processes in the body and other factors can cause liver and spleen pathologies. For example, in children aged 5-7 years, the increase in the liver is of an age-specific character, therefore, hepatomegaly is moderate. Such a physiological phenomenon does not require medical intervention and treatment. But if this occurs in older children, then the cause may be in disorders of the body or diseases.

The danger is not just an enlarged liver, but the accompanying symptomatology. If the baby complains of pain under the ribs, rashes and changes in skin pigmentation, the appearance of vascular asterisks on the abdomen, nausea and vomiting, fatigue and loss of appetite, this indicates serious health problems. Any of the above symptoms in combination with an enlarged liver is an excuse to immediately seek medical help. The doctor will prescribe a test to confirm or exclude liver damage.

The causes of hepatomegaly in children are diverse, but doctors identify 6 main factors that can lead to problems, consider them:

  • Inflammatory diseases - congenital infections (herpes, cytomegalovirus, rubella), toxic and medicinal damage to the body, closing of the lumen of the biliary tract, hepatitis A, B, C, parasitic diseases.
  • Metabolic disorders - a violation of the structure and metabolism of glycogen, a violation of protein metabolism, Wilson's disease, lipid metabolism disorders, mucopolysaccharidosis, porphyria and others.
  • Liver damage (infiltrative) - hemolytic diseases of newborns, lymphoma, leukemia, hepatoma, metastases, hematopoiesis in "atypical" organs, histiocytosis.
  • Violation of the outflow of bile and blood - cirrhosis, stenosis, thrombosis, atresia, heart failure, Wilson's disease.
  • The primary damage to the liver is multicystosis, congenital liver fibrosis, biliary cirrhosis and others.
  • Hyperplasia of Kupffer cells, which absorb and process dead cells - granulomatous hepatitis, sepsis, hypervitaminosis.
  • False hepatomegaly - develops due to pathology of the respiratory system, for example, with pulmonary emphysema. Enlarged organs expel the liver from under the ribs

Hepatomegaly in children is a state of the body, not a disease. Therefore, special attention is paid to the symptomatology and diagnosis of the causes of this pathology. For examination, the child is given a percussion of the abdominal circumference and palpation. Particular attention is drawn to a pronounced venous vasculature in the abdomen, changes in pigmentation of the skin and mucous membranes, symptoms of intoxication, pain and heaviness. If the hepatomegaly is moderate, then there are no objective symptoms.

For reliable confirmation of liver damage, an ultrasound is performed. Such a diagnosis is fully justified in the absence of external manifestations of hepatomegaly. Ultrasound can detect various forms of the disease, detect abnormalities in the structure of the organ. Based on the results of the examination, suitable treatment is selected. But hepatomegaly itself is not treated, the treatment is subject to the underlying disease that caused this pathology.

Hepatomegaly in the fetus

Hepatomegaly in the fetus indicates that the liver of the embryo is more than normal. This pathology is easily diagnosed, as the increase in the organ leads to an increase in the abdomen, which can not be ignored during the ultrasound of the pregnant woman. The primary task of the doctor is to determine the causes that caused the pathology of the unborn child. It is on this depends the tactics of treatment and prognosis.

There are many reasons that cause hepatomegaly in the fetus, consider them in more detail:

  • Intrauterine infections - the negative effects of toxoplasmosis, cytomegalovirus, chicken pox, rubella, Coxsackie virus, syphilis and even rhesus conflict, can lead to an increase in the liver. 
  • Various hepatic formations.
  • Metabolic disorders.
  • Heart failure.
  • Hemolysis.
  • Syndrome Datsna, Beckwita - Wiedemann, Zellweger.

If hepatomegaly occurs against the background of intrauterine infection, this leads not only to an increase in the organ, but also to the appearance of small hyperechoic inclusions. As for neoplastic lesions in the liver in the fetus, it can be hemangioma, hepatoblastoma, adenoma, mesenchymal hamartoma and others.

Quite often, the enlargement of the liver is accompanied by pathologies of the spleen. As a rule, hepatomegaly is detected in the second half of pregnancy. But the most important thing in finding these problems is to exclude Down syndrome. The tactics of the introduction of pregnancy directly depends on the causes that caused the pathology, since isolated hepatomegaly in the fetus occurs very rarely.

Hepatomegaly in newborns

Hepatomegaly in newborns is considered the norm if it is of an unexpressed nature. But if the liver protrudes more than 2 cm, then this indicates an organ disease. The list of diseases is extensive, since hepatomegaly does not appear by itself, but signals the presence of diseases of the body or organism. The hepatomegaly syndrome can be associated with eating disorders, autoimmune processes, or a condition after vaccination.

The main causes of pathology are found in inflammatory and dystrophic processes in the liver parenchyma. Hepatomegaly in newborns can also be a physiological phenomenon. Let's consider the main causes of liver enlargement in infants:

  • Infectious diseases - virtually all viral infections in babies cause compaction and enlargement of the liver.
  • Diseases of the cardiovascular and respiratory system - pathology can develop due to right ventricular failure. •
  • Blockage of the biliary tract and bile duct cysts - this disease is very rare, but also causes an increase in the liver. The main symptoms are fever, and when trying to palpate the liver, the baby begins to cry.
  • Cholangitis - hepatomegaly appears due to inflammation of the bile duct. The disease is accompanied by high fever and pain in the right hypochondrium.
  • The Debra syndrome - pathology occurs in children who develop poorly. Due to the developmental lag in the liver, glycogen and fat accumulate, which can cause fatty hepatosis.
  • Disorders of lipid metabolism - in this case the newborn has severe diarrhea, vomiting and skin xanthomas.
  • Echinococcosis is a disease caused by the introduction into the liver of larvae of tapeworms. Pathology causes nodal enlargement of the organ. The main cause of echinococcosis is contact with animals, especially dogs.
  • The Voringer syndrome - hepatomegaly occurs in children with autonomic symptoms and abnormal body weight.
  • Mauriac's syndrome is a complication of diabetes mellitus, which causes the accumulation of fat in the baby's liver.
  • Liver tumors - hepatoblastomas and isolated organ tumors are extremely rare, but can metastasize and affect both one and both lobes of the liver.
  • Disease Girke - a disease of accumulation of glycogen. In addition to enlarging the liver, causes convulsions, increased lactic acid in the blood and the release of acetoacetic acid in the urine.

Despite such a variety of causes and factors that cause hepatomegaly in newborns, there are common symptoms that can point to the disease, consider them:

  • Jaundice of the skin - persistent jaundice appears with many liver diseases. Particular attention should be paid to the color of the feces of the child. If the baby has a colorless stool, you should immediately seek medical help.
  • Vascular asterisks in the abdomen.
  • Nausea, company, poor appetite.
  • Lethargy, increased fatigue.
  • Navel swelling - this happens only with severe liver and abdominal cavity diseases. The abdomen of the child is greatly increased due to the accumulation of fluid.

Particular attention is paid to HIV-infected newborns with hepatomegaly. In some cases it is the enlargement of the liver that serves as an early symptom of HIV infection. In such children, the spleen is enlarged, upper respiratory tract infections, dermatitis, parotitis, enlarged lymph nodes appear. If the disease is in a moderate course, the baby may suffer from prolonged candidiasis of the oral cavity, hepatitis, diarrhea, fever, anemia, meningitis, or sepsis.

Hepatomegaly in pregnancy

Hepatomegaly during pregnancy occurs quite often. As a rule, problems with the liver occur in the last trimester. Due to the increase in the uterus, the liver is shifted up to the right, the organ becomes more voluminous and full-blooded. At the same time, excursions of the diaphragm are reduced, which causes difficulties in excretion of bile. In addition, during pregnancy, a number of changes are observed, which must necessarily be taken into account when examining the organ. For example, the appearance of vascular asterisks on the skin, increased content of fatty acids, triglycerides in serum or cholesterol. All this is due to the influence of estrogen and progesterone and an increase in the volume of circulating blood.

All liver diseases that occur during pregnancy and cause hepatomegaly are divided into three groups:

  • Lesions of the organ associated with pregnancy (occur only in pregnant women).
  • Intrahepatic cholestasis of pregnant women is a rare disease that is diagnosed in 20% of women. At the heart of the pathology lies a hereditary predisposition to an incorrect cholestatic reaction to estrogens and progesterones produced during gestation.
  • Lesion of the liver due to manifestations of toxicosis (with excessive vomiting). A similar phenomenon occurs in 2% of pregnant women and develops between the 4th and 10th week of gestation, it stops by the 20th week of pregnancy. Excessive vomiting leads to dehydration of the body, protein catabolism, electrolyte disorders and weight loss.

In addition to the above-described reasons, hepatomegaly during pregnancy can arise due to vascular stagnation, fatty hepatosis, diabetes, leukemia, inflammatory diseases, tumoral neoplasms and cysts.

Where does it hurt?

Forms

Hepatomegaly is included in the international classification of diseases 10 revision. That is, a single normative document used to take into account the incidence, causes of death and the reasons for people to seek medical help.

Hepatomegaly and splenomegaly are not classified elsewhere and are part of the R16 group:

  • R16.0 Hepatomegaly, not elsewhere classified.
  • Hepatomegalia BDU.
  • R16.1 Splenomegaly, not elsewhere classified.
  • Splenomegaly of the BDU.
  • R16.2 Hepatomegaly with splenomegaly, not elsewhere classified.
  • Hepatosplenomegaly of the BDU.

Unexpected hepatomegaly

Unexpected hepatomegaly is characterized by an increase in the liver by 1-2 cm. Such changes do not cause painful symptoms, therefore it is possible to diagnose their presence only with the help of ultrasound. But the process of deformation of the liver sooner or later begins to make itself felt by the characteristic clinical symptoms. Since without proper treatment, unexpressed hepatomegaly progresses.

Typical symptoms of unexpressed hepatomegaly are weakness, rapid fatigue, which occurs without physical and other stresses. In the abdominal cavity there are unpleasant sensations of severity and discomfort, possible heartburn, bad breath, itching and dyspepsia. If you have the above symptoms, you need to undergo a complete examination, since palpation is ineffective. The patient is assigned an ultrasound examination, according to the results of which it is possible to evaluate the condition and dimensions of the liver. In addition to ultrasound may appoint a computerized tomography of the abdominal cavity, which provides more complete and reliable information about the condition of the organ.

If a change in the liver is found, the patient is prescribed a diet and medication. The first step to recovery is proper nutrition and rejection of bad habits. If the pain in the right hypochondrium becomes stronger, the doctor prescribes preparations to strengthen the lining of the liver cells: Karsil, Ursosan, Essentiale forte and others.

Moderate hepatomegaly

Moderate hepatomegaly is diagnosed in patients with mild diffuse liver changes and associated clinical symptoms. Doctors use this term to describe abnormalities in the structure and size of the organ that do not correspond to the norm.

Moderate liver enlargement occurs with prolonged abuse of alcohol and unbalanced diet. As a rule, this diagnosis can be seen after ultrasound or CT of the abdominal cavity. Without proper treatment and a healthy lifestyle, the pathology progresses and acquires a pronounced character.

Pronounced hepatomegaly

Expressed hepatomegaly indicates pathological, but still reversible changes in liver size. As a rule, this is observed with hemoblastoses and leukemias, because of massive infiltration of the organ tissues with malignant cells. This provokes the appearance of foci of necrosis and the proliferation of connective tissue. In these cases, the liver reaches a huge size, occupying most of the abdominal cavity, thereby disrupting the work of other internal organs.

With severe hepatomegaly, doctors assess not only the size of the organ, but also the structure, contours and pattern of the tissue. A significant increase in certain areas, the appearance of stony consistency or tumor foci, indicates a certain disease. Rapid enlargement of the liver is possible with fatty infiltration and cardiovascular diseases.

Diagnostics of the hepatomegaly

Diagnosis of hepatomegaly is the basis of future treatment, so the tactics of therapy of the underlying disease that caused the enlargement of the liver depend on its results. The doctor examines the patient, conducts palpation and percussion of the liver. Particular attention is paid to collecting an anamnesis of the disease. The patient should tell the doctor if there are abdominal pains, vomiting and nausea, unusual stool color, yellowing of the skin, a feeling of excessive heaviness or a lump in the abdomen. For the purpose of further examination, the doctor finds out whether the patient is taking any medications, what amount of alcohol is consumed and about nutrition.

Characteristic for hepatomegaly symptoms give all the grounds for conducting a detailed examination of the body. As a rule, patients are prescribed:

  • Biochemical blood test (serum bilirubin, thymol test, alkaline phosphatase, total protein and proteinogram, ALT and AST).
  • Computer tomography and magnetic resonance imaging of the abdominal cavity.
  • Ultrasound examination of the abdominal cavity organs.
  • Radiography.
  • Analysis of liver function, including blood coagulation tests.

In some cases, to clarify the processes in the liver, a biopsy is performed. This analysis is done using laparoscopy. All of the above diagnostic methods allow you to understand the situation and accurately determine the cause of hepatomegaly.

Ultrasound signs of hepatomegaly

Ultrasound signs of hepatomegaly appear on the scans as focal lesions. An enlarged liver is characterized by the presence of zones with a reduced accumulation of radionuclides. During the examination, the doctor reveals topographic changes in the position, size of the organ, changes in the structure of the hepatic segments.

Ultrasound examination can detect any focal lesions of the liver. Diagnosis makes it possible to determine the degree of hepatomegaly, the state of the spleen and other internal organs. More extensive information for studying the causes of liver enlargement is obtained with the help of echogepatography.

Echoes of hepatomegaly

Echoes of hepatomegaly play an important role in determining the diseases that caused liver enlargement.

  • If the pathology is caused by cardiac insufficiency, acute hepatitis or parasitic diseases, then a uniform echostructure of the organ is preserved.
  • If a heterogeneous ehostruktura liver, it can indicate fatty hepatosis, cirrhosis, chronic hepatitis.
  • When inflammation or necrosis occurs in liver tissues that caused disturbances in the echogenic structure, one can speak about the presence of tumor neoplasms, cysts or abscesses.

Echoes of hepatomegaly allow you to accurately determine the degree of pathology: unexpressed, moderate and severe increase in the liver.

What do need to examine?

Differential diagnosis

Differential diagnosis of hepatomegaly is necessary in order to pinpoint the cause of liver damage and separate it from other diseases with similar symptoms. Particular attention is paid to the size of the organ parts. Thus, an increase in the right-side margin without differential diagnosis can be considered as a neoplasm of the colon, gallbladder, or kidney. Another important stage of diagnosis is to delimit hepatomegaly from hepatopathy and hepatosis. To accurately determine the causes of liver enlargement, palpation is performed in different positions and ultrasound examination.

  • When diagnosing hepatomegaly with acute viral hepatitis, information about recent transfusions of blood or its components is important. Multiple injections, parenteral manipulation, as well as the belonging of the patient to the risk group or the presence of an epidemiological anamnesis of an unfavorable nature. In order to exclude acute viral hepatitis, the markers of viruses B, C, D, G are tested. This allows to establish the phase of virus replication and to reveal its presence.
  • Hepatomegaly is one of the first symptoms of liver cirrhosis, so this disease is also important to differentiate. Cirrhosis causes portal hypertension, functional deficiency and liver tightening.
  • Portal hypertension is accompanied by circulatory disorders, which causes an increase in the organ. To recognize this disease, a gastroscopy is performed, which reveals the expansion of the veins of the stomach and esophagus, and a biopsy is possible.
  • Liver enlargement and pain in the right upper quadrant are also characteristic of obstruction of the hepatic veins, which leads to violations of the outflow of blood from the organ (Badd-Chiari syndrome). The patient complains of fever, weakness and ascites. For diagnosis, ultrasound dopplerography is performed with an assessment of blood flow. The main sign of this disease is hepatomegaly with a complete impairment of liver function. It is mandatory to conduct a puncture biopsy.
  • It is extremely important to recognize the accumulation diseases (amyloidosis, fatty hepatosis, hepatocerebral dystrophy, hemochromatosis), which at the initial stage give one single symptom - hepatomegaly. To identify fatty hepatosis use CT and ultrasound. When diagnosing hemochromatosis, special attention is paid to the results of blood tests. To confirm the diagnosis of hepatocerebral dystrophy, attention is paid to the presence of neurological symptoms and puncture biopsy data.
  • When diagnosing diseases of the cardiovascular system that cause hepatomegaly, you need to remember about possible pericarditis in the right ventricle. As a rule, in this case, a history of injuries in the heart or tuberculosis. The first signs of the disease cause pain in the right hypochondrium, an increase in the left lobe of the liver, shortness of breath, and increased blood pressure.

Who to contact?

Treatment of the hepatomegaly

Treatment of hepatomegaly completely depends on the results of diagnosis and on the etiological component of the pathology. Treatment should be aimed at eliminating the causes of liver damage and fighting the painful symptoms. Compulsory adherence to a special diet, gentle exercise and preventive hepatoprotective therapy.

If hepatitis is caused by hepatitis, then antiviral and hepatoprotective therapy leads to complete recovery and restoration of normal liver size. With cirrhosis, which causes irreversible replacement of liver cells with a connective tissue, complete restoration of the liver is impossible. Treatment is aimed at replenishment of the body's enzyme deficiency and maintenance of normal functioning. Treatment is reduced to palliative therapy, against which hepatomegaly is slowly progressing and the patient's condition is steadily deteriorating.

If the patient has an increase in the liver against compensated cirrhosis, then it is recommended to limit physical activity, to maintain a diet with enough vitamins and protein, and also to completely abandon the use of alcohol. Active viral cirrhosis B and C causes replication of the virus, so treatment is medication that prevents the development of hepatocarcinoma. If cirrhosis is of an autoimmune nature, then glucocorticosteroids are used for therapy.

In hepatomegaly caused by hepatic insufficiency with ascites and sodium chloride deficiency, diuretics are prescribed for treatment. If the underlying disease progresses, is accompanied by cirrhosis of the liver or a patient under 60, organ transplantation is possible.

Treatment of hepatomegaly with alternative means

Treatment of hepatomegaly with alternative agents is performed at any stage of the disease. But the best treatment is a moderate and insignificant increase in the liver. Consider the most effective recipes for alternative therapy for hepatomegaly.

  • To normalize the functioning of the liver and restore its normal size, the following folk method is suitable. Take the herbaceous motherwort and sage, in a 1: 1 ratio. Add to them equal shares of roots of a dandelion, chicory and a peony, carefully mix. The resulting mixture pour 500 ml of water, boil and keep on low heat for 30-40 minutes. Ready-made infusion should be well wrapped and allowed to settle for a couple of hours. After this, carefully strain and drink the whole broth for several meals during the day.
  • The medicinal solution from honey favorably affects not only the functioning of the body, but also the liver. Every morning and before going to bed, drink a drink from 2 tablespoons of honey, 200 ml of warm water and 2 tablespoons of lemon juice.
  • Recover the consequences of hepatomegaly with a pumpkin. It is recommended to eat 500 grams of grated raw pumpkin a day. If the raw vegetable is not to your taste, then you can make pumpkin juice, boiled pumpkin or baked. Healing properties also exist in hepatomegaly. It is recommended to eat a half of boiled red beet every day or make salads from this vegetable with the addition of olive oil.
  • Pickle sauerkraut - this is the simplest and most popular means for treating enlarged liver. Mix a glass of brine with a glass of tomato juice and drink in small portions throughout the day.
  • Freshly squeezed strawberry juice is a remedy for pain in the right upper quadrant and the initial stages of hepatomegaly. Morse from strawberries and cranberries has healing properties. If there are no contraindications, then every morning before eating it is necessary to drink a glass of juice from berries.
  • Ripe green apples are an excellent tool for maintaining the shape and eliminating hepatomegaly. Prepare natural juice from ripe green apples, approximately 500-600 ml. Mix it with ¼ cup of honey and mix thoroughly. The received product should be taken at ½ cup 4-5 times a day.
  • Healing properties are unrefined sunflower and olive oil. For therapy, you must drink ¼ cup in the morning and before going to bed. In this case, after consuming the oil, you need to lie on your right side, put a heating pad under it and lie down for 40-60 minutes.
  • Walnut kernels in combination with honey is an excellent tool for strengthening immunity and preventing liver enlargement. Mix the nucleoli 5-7 nuts with an equal amount of honey, take a spoonful every day.
  • Juniper berries also help to eliminate the enlargement of the liver, only take them on an empty stomach, that is, between basic meals. For a day you can eat up to 15 berries, start with 2-3 and gradually increase the dose.

Nutrition for hepatomegaly

Nutrition for hepatomegaly is one of the most important conditions for restoring liver health. A healthy balanced diet has a beneficial effect on the liver and the body as a whole. Consider the basic rules of nutrition in hepatomegaly:

  • Eat at least 6 times a day, that is, three main meals and three snacks. It is recommended to take food in small fractions.
  • It is necessary to completely abandon fatty and fried. Dishes should be steamed, boiled or baked. A day is allowed to consume no more than 70 grams of fats, while animal fats should be replaced with vegetable fats.
  • From the food you need to completely exclude bakery products, sugar and any sweets.
  • It is forbidden to eat fatty meat and fish, fat, smoked, spicy, canned or salty foods.
  • In the diet should be stewed and boiled vegetables, cereals, steamed or baked fish, poultry. It is recommended to eat more seasonal vegetables and fruits.

Diet for hepatomegaly

The diet for hepatomegaly is aimed at normalizing the functioning of the liver. The diet is a five-time meal every 3-4 hours with certain restrictions in the choice of products. These requirements completely correspond to the diet number 5 for Pevzner. In addition to prescribed medications for the treatment of hepatomegaly, recovery can be accelerated by eating. Failure to comply with dietary rules can have very serious consequences for the body and trigger inflammation of the liver, which will only exacerbate hepatomegaly.

The first rule of normal work of this body is a sufficient amount of sugar, better of course fruit. So, in the autumn time in the diet can include grapes, because it contains potassium, which strengthens the liver. Any sweet vegetables and fruits can be consumed in any form, a pumpkin is very useful.

Permitted products:

  • Vegetable oils.
  • Sea and river lean fish.
  • Fresh vegetables and fruits, greens.
  • Milk and dairy products.
  • Honey, pastille, jam.
  • Dried fruits.
  • Cereals.
  • Low-fat meat of poultry.
  • Vegetable, cereal and milk soups.
  • Sauerkraut.

Nutrition for hepatomegaly requires dinner no later than seven in the evening. It is strictly forbidden to overeat, between meals should be intervals of 2.5-3 hours, but no more.

Contraindicated products:

  • Butter (more than 50 grams per day) and margarine.
  • Eggs (no more than 2 per week).
  • Sausage and sausage products.
  • Pork, goose meat, lamb.
  • Cheese with a high fat content.
  • Marinated and fried foods.
  • Spicy condiments, sauces, vinegar.
  • Legumes and onions.
  • Tomato juice.
  • White refined sugar and any confectionery.
  • Chocolate.
  • Canned food.
  • Bakery products.

Diet and hepatomegaly are two indivisible concepts. Since without proper nutrition it is impossible to completely restore the liver and the health of the body. After diagnosis, the doctor can add additional nutritional restrictions that are associated with a specific disease that causes an organ increase. Duration of the diet is also determined by the attending physician, but some recommendations will have to be observed throughout life.

Prevention

Prevention of hepatomegaly depends on the underlying disease that caused the enlargement of the liver. To prevent hepatomegaly, you must follow a healthy diet, give up harmful habits (alcohol, smoking) and control weight. With special care and only after medical approval you can take medications, since they too can cause toxic damage to the liver.

For preventive purposes it is recommended to lead an active way of life, to go in for sports. An obligatory condition for good health is a full-fledged healthy sleep and timely treatment for medical help with side symptoms of the body.

Forecast

The prognosis of hepatomegaly depends on the nature of the occurrence of this pathology and the severity of the disorders. If the increase in the liver is due to viral and infectious lesions, then it is curable. Antiviral therapy is especially effective in the early stages, and the risk of transition to a pronounced form is 5%. With liver pathologies caused by toxic damage, the prognosis worsens. An unfavorable prognosis is cirrhosis, uncontrolled fatty hepatosis, fulminant forms of hepatitis.

Any diseases that caused not only an increase in the organ but also changes in the liver parenchyma are characterized by rapid progression and the development of severe consequences. In 30% of cases, a lethal outcome of complications of the underlying disease that caused hepatomegaly occurs. It can be intraperitoneal bleeding, severe infectious diseases, violations of the liver's antitoxic function, and others.

Hepatomegaly is a sign of problems with the liver and the body. The regular passage of medical examinations and ultrasound studies, allow to reveal the increase in the liver in the early stages. Due to this, it is possible to begin timely treatment of the underlying disease and to restore the size of the organ and its functional capabilities.

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