II. Causes: Hepatomegaly

  1. Liver displacement (Palpable liver, no Hepatomegaly)
    1. Obstructive Lung Disease (Asthma, COPD)
    2. Adjacent mass (Cholecystitis, abscess)
    3. Thin patient
  2. Infectious
    1. AIDS
    2. Hepatic Abscess (e.g. Amebiasis)
    3. Relapsing Fever
    4. Echinococcal cysts
    5. Schistosomiasis
    6. Kala Azar
  3. Hepatitis
    1. Alcoholic Hepatitis
    2. Autoimmune Hepatitis
    3. Viral Hepatitis
  4. Congestive Hepatomegaly (often precedes edema)
    1. Congestive Heart Failure (systemic venous congestion)
    2. Constrictive Pericarditis
    3. Tricuspid stenosis
  5. Miscellaneous
    1. Wilson's Disease
    2. Fatty Liver
    3. Cirrhosis
    4. Hemochromatosis
    5. Primary Sclerosing Cholangitis
    6. Cholestasis
    7. Mixed cryoglobulinemia
    8. Congenital hepatic fibrosis
    9. Polycystic liver disease
    10. Hurler's Syndrome
    11. Gaucher's Disease
    12. Sarcoidosis
    13. Amyloidosis
  6. Malignancy
    1. Intraabdominal malignancy
    2. Pancreatic Cancer
    3. Hepatocellular Carcinoma
  7. Medication toxicity
    1. See Hepatotoxins
    2. NRTI (e.g. Stavudine)

III. Causes: Hepatosplenomegaly

  1. See Splenomegaly
  2. Babesiosis
  3. Chaga's Disease
  4. Mononucleosis
  5. Malaria
  6. Beta Thalassemia major
  7. Essential-mixed cryoglobulinemia
  8. Viral Arthritis (e.g. Parvovirus)
  9. Severe congestive Hepatomegaly (see Hepatomegaly)
  10. Acute Lymphoblastic Leukemia
  11. Mast cell disorders (mastocytosis)

IV. Evaluation

  1. Step 1: Confirm Liver Enlargement versus displacement
  2. Step 2: Check Serum AST and Serum ALT
    1. If positive then go to step 3
    2. If negative then go to step 4
  3. Step 3: Check for Viral Hepatitis
  4. Step 4: Check Abdominal CT for Liver Lesion
  5. Step 5: Consider congestive Hepatomegaly (e.g. CHF)
  6. Step 6: Consider liver biopsy

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Ontology: Hepatomegaly (C0019209)

Definition (MSHCZE) Zvětšení jater. Může mít řadu příčin (hepatitida, nádor, městnání krve při srdečním selhávání, ukládání tuku – steatóza aj.). Zvětšená játra lze vyhmatat při vyšetření břicha, jejich zvětšení dobře prokáže ultrazvuk. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI_NCI-GLOSS) Enlarged liver.
Definition (NCI) Abnormal enlargement of the liver.
Definition (MSH) Enlargement of the liver.
Concepts Sign or Symptom (T184)
MSH D006529
ICD9 789.1
ICD10 R16.0
SnomedCT 207231001, 207233003, 207232008, 158515001, 158513008, 158514002, 80515008
English Hepatomegaly, HEPATOMEGALY, LIVER ENLARGEMENT, Liver enlargement, [D]Hepatomegaly (context-dependent category), [D]Hepatomegaly NOS (context-dependent category), [D]Liver enlargement (context-dependent category), [D]Hepatomegaly, [D]Hepatomegaly NOS, [D]Liver enlargement, liver enlargement, hepatic enlargement, enlarged liver, hepatomegaly (physical finding), hepatomegaly, Enlarged Liver, Liver, Enlarged, Hepatomegaly NOS, Hepatomegaly [Disease/Finding], enlargement of liver, Enlarged;liver, large liver, enlarged livers, [D]Hepatomegaly NOS (situation), [D]Hepatomegaly (situation), [D]Liver enlargement (situation), Liver enlarged, Large liver, Large liver (disorder), enlargement; liver, liver; enlargement, Enlargement of liver
French HEPATOMEGALIE, AUGMENTATION DU VOLUME DU FOIE, Hépatomégalie, Hypertrophie du foie, Hypertrophie hépatique
Portuguese HEPATOMEGALIA, Aumento de volume do fígado, AUMENTO DE VOLUME DO FIGADO, Fígado Hipertrófico, Hepatomegalia, Fígado Aumentado
Spanish HEPATOMEGALIA, hígado grande, Aumento de tamaño del hígado, [D]hepatomegalia, SAI (categoría dependiente del contexto), [D]agrandamiento del hígado (categoría dependiente del contexto), [D]hepatomegalia (categoría dependiente del contexto), HIGADO AUMENTADO DE TAMANO, [D]hepatomegalia, SAI (situación), [D]hepatomegalia, SAI, [D]agrandamiento del hígado, [D]hepatomegalia, [D]hepatomegalia (situación), [D]agrandamiento del hígado (situación), hepatomegalia (trastorno), hepatomegalia, Hepatomegalia, Hígado Agrandado
German HEPATOMEGALIE, Lebervergroesserung, LEBERVERGROESSERUNG, Hepatomegalie, Lebervergrößerung
Dutch leververgroting, lever; vergroting, vergroting; lever, hepatomegalie, Hepatomegalie, Vergrote lever
Swedish Leverförstoring
Japanese カンシュダイ, 肝腫, 肝腫脹, 肝腫大, 肝臓腫大
Czech hepatomegalie, Hepatomegalie, Zvětšení jater, zvětšení jater
Finnish Hepatomegalia
Italian Fegato ingrossato, Epatomegalia
Russian GEPATOMEGALIIA, ГЕПАТОМЕГАЛИЯ
Polish Hepatomegalia, Powiększenie wątroby
Hungarian Májmegnagyobbodás, Hepatomegalia
Norwegian Forstørret lever, Hepatomegali