| 词条 | Hepatomegaly |
| 释义 |
| name = Hepatomegaly | image = Se000.jpg | caption = Computerized tomography of hepatomegaly | symptoms = | complications = | onset = | duration = | types = | causes = Liver abscess (pyogenic abscess), Malaria[1] | risks = | diagnosis = Abdominal ultrasonography[2] | differential = | prevention = | treatment = Prednisone and azathioprine[3] | medication = | prognosis = | frequency = | deaths = }}Hepatomegaly is the condition of having an enlarged liver.[1] It is a non-specific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.[2] Symptoms/signsSymptoms having to do with hepatomegaly can include several, among them the individual may experience some weight loss, poor appetite and lethargy (jaundice and bruising may also be present)[2] CausesAmong the causes of hepatomegaly are the following: Infective{{columns-list|colwidth=22em|
Neoplastic
Biliary
Metabolic
Drugs (and alcohol)
Congenital
Others
}} MechanismThe mechanism of hepatomegaly consists of vascular swelling, inflammation (due to the various causes that are infectious in origin) and deposition of (1) non-hepatic cells or (2) increased cell contents (such due to iron in hemochromatosis or hemosiderosis and fat in fatty liver disease)[12] DiagnosisSuspicion of hepatomegaly indicates a thorough medical history and physical examination, wherein the latter typically includes an increased liver span. {{citation needed|date=January 2018}} On abdominal ultrasonography, the liver can be measured by the maximum dimension on a sagittal plane view through the midclavicular line, which is normally up to 18 cm in adults.[13] It is also possible to measure the cranio-caudal dimension, which is normally up to 15 cm in adults.[13] This can be measured together with the ventro-dorsal dimension (or depth), which is normally up to 13 cm.[13] Also, the caudate lobe is enlarged in many diseases. In the axial plane, the caudate lobe should normally have a cross-section of less than 0.55 of the rest of the liver.[13] On CT scan, hepatomegaly has been defined as a longitudinal axis > 15.5 cm at the hepatic midline, or > 16.0 cm at the midclavicular line[15] WorkupBlood tests should be done, importantly liver-function series, which will give a good impression of the patient's broad metabolic picture.{{medical citation needed|date=February 2016}} A complete blood test can help distinguish intrinsic liver disease from extrahepatic bile-duct obstruction.[16] An ultrasound of the liver can reliably detect a dilated biliary-duct system,[17] it can also detect the characteristics of a cirrhotic liver,.[18] Computerized tomography (CT) can help to obtain accurate anatomical information, in individuals with hepatomegaly for the purpose of a complete diagnosis.[19]TreatmentTreatment of hepatomegaly will vary depending on the cause of the liver enlargement and hence accurate diagnosis is the primary concern. In the case of auto-immune liver disease, prednisone and azathioprine may be used for treatment.[20] In the case of lymphoma the treatment options include single-agent (or multi-agent) chemotherapy and regional radiotherapy, also surgery may be an option in specific situations. Meningococcal group C conjugate vaccine are also used in some cases.[21] In primary biliary cirrhosis ursodeoxycholic acid helps the bloodstream remove bile which may increase survival in some affected individuals.[22] {{clear}}See also
References1. ^1 2 3 4 5 6 7 8 {{Cite web| url = https://www.nlm.nih.gov/medlineplus/ency/article/003275.htm| title = Hepatomegaly: MedlinePlus Medical Encyclopedia| website = www.nlm.nih.gov| access-date = 2016-02-27}} 2. ^1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 {{Cite web| url = http://patient.info/doctor/hepatomegaly| title = Hepatomegaly. Read about Hepatomegaly (enlarged liver) {{!}} Patient| website = Patient| language = en-GB| access-date = 2016-02-27}} 3. ^{{Cite book|url=https://books.google.com/books?id=DdBJ6jCf8KgC|title=Encyclopedia of Molecular Mechanisms of Disease: With 213 Tables|last=Lang|first=Florian|date=2009-03-19|publisher=Springer Science & Business Media|page=824|isbn=9783540671367|language=en}} 4. ^{{Cite web|url=https://www.cdc.gov/parasites/echinococcosis/health_professionals/|title=CDC - Echinococcosis - Resources for Health Professionals|last=Prevention|first=CDC - Centers for Disease Control and|website=www.cdc.gov|language=en-us|access-date=2016-03-11}} 5. ^{{Cite web|url=http://patient.info/doctor/leptospirosis-weils-disease|title=Leptospirosis (Weil's Disease) {{!}} Doctor {{!}} Patient|website=Patient|language=en-GB|access-date=2016-03-11}} 6. ^{{Cite book|url=https://books.google.com/books?id=O3nGBAAAQBAJ|title=Homeostasis - Tumor - Metastasis|last=Banfalvi|first=Gaspar|date=2013-10-16|publisher=Springer Science & Business Media|page=145|isbn=9789400773356|language=en}} 7. ^{{Cite web|url=http://rarediseases.org/rare-diseases/cholesteryl-ester-storage-disease/|title=Cholesteryl Ester Storage Disease - NORD (National Organization for Rare Disorders)|website=NORD (National Organization for Rare Disorders)|language=en-US|access-date=2016-03-11}} 8. ^{{Cite web|url=http://patient.info/doctor/hunters-syndrome|title=Hunter's Syndrome. MPS II information; symptoms {{!}} Patient|website=Patient|language=en-GB|access-date=2016-03-11}} 9. ^{{Cite web|url=http://www.omim.org/entry/214100 |title=OMIM Entry - # 214100 - PEROXISOME BIOGENESIS DISORDER 1A (ZELLWEGER); PBD1A |website=www.omim.org |access-date=2016-03-11 }}{{dead link|date=April 2017 |bot=InternetArchiveBot |fix-attempted=yes }} 10. ^{{Cite web|url=https://ghr.nlm.nih.gov/condition/carnitine-palmitoyltransferase-i-deficiency|title=CPT I deficiency|date=2016-03-07|website=Genetics Home Reference|access-date=2016-03-11}} 11. ^{{Cite web|url=http://patient.info/doctor/sarcoidosis-pro|title=Sarcoidosis {{!}} Doctor {{!}} Patient|website=Patient|language=en-GB|access-date=2016-03-11}} 12. ^{{Cite book|url=https://books.google.com/?id=FIV-NYPRCzEC&pg=PA469&dq=Hepatomegaly+mechanism#v=onepage&q=Hepatomegaly%2520mechanism&f=false|title=Mechanisms of Clinical Signs|last=Dennis|first=Mark|last2=Bowen|first2=William Talbot|last3=Cho|first3=Lucy|date=2012-01-01|publisher=Elsevier Australia|page=469|isbn=9780729540759|language=en}} 13. ^1 2 3 4 5 {{cite web|url=http://www.kosmos-design.co.uk/efsumb-ecb/ecbse-ch02-ultrasoundliver.pdf|title=Ultrasound of the liver - EFSUMB – European Course Book|website=European federation of societies for ultrasound in medicine and biology (EFSUMB)|author=Christoph F. Dietrich, Carla Serra, Maciej Jedrzejczyk|date=2010-07-28}} 14. ^{{cite journal|last1=Rocha|first1=Silvia Maria Sucena da|last2=Ferrer|first2=Ana Paula Scoleze|last3=Oliveira|first3=Ilka Regina Souza de|last4=Widman|first4=Azzo|last5=Chammas|first5=Maria Cristina|last6=Oliveira|first6=Luiz Antonio Nunes de|last7=Cerri|first7=Giovanni Guido|title=Determinação do tamanho do fígado de crianças normais, entre 0 e 7 anos, por ultrassonografia|journal=Radiologia Brasileira|volume=42|issue=1|year=2009|pages=7–13|issn=0100-3984|doi=10.1590/S0100-39842009000100004}} 15. ^{{cite journal|last1=Vermelho|first1=Marli Batista Fernandes|last2=Correia|first2=Ademir Silva|last3=Michailowsky|first3=Tânia Cibele de Almeida|last4=Suzart|first4=Elizete Kazumi Kuniyoshi|last5=Ibanês|first5=Aline Santos|last6=Almeida|first6=Lanamar Aparecida|last7=Khoury|first7=Zarifa|last8=Barba|first8=Mário Flores|title=Abdominal alterations in disseminated paracoccidioidomycosis: computed tomography findings|journal=Radiologia Brasileira|volume=48|issue=2|year=2015|pages=81–85|issn=0100-3984|doi=10.1590/0100-3984.2013.0025|pmid=25987748|pmc=4433296}} 16. ^{{Cite book|url=https://books.google.com/books?id=40Z9CAAAQBAJ|title=Goldman-Cecil Medicine|last=Goldman|first=Lee|last2=Schafer|first2=Andrew I.|date=2015-04-21|publisher=Elsevier Health Sciences|page=991|isbn=9780323322850|language=en}} 17. ^{{Cite journal|last=Meacock|first=L M|last2=Sellars|first2=M E|last3=Sidhu|first3=P S|date=2010-07-01|title=Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound|journal=The British Journal of Radiology|volume=83|issue=991|pages=615–627|doi=10.1259/bjr/60619911|issn=0007-1285|pmc=3473688|pmid=20603412}} 18. ^{{Cite book|url=https://books.google.com/books?id=HzC5BAAAQBAJ|title=Diseases of the Liver in Children: Evaluation and Management|last=Murray|first=Karen F.|last2=Horslen|first2=Simon|date=2013-12-11|publisher=Springer Science & Business Media|page=199|isbn=9781461490050|language=en}} 19. ^{{Cite book|url=https://books.google.com/books?id=E3tYBAAAQBAJ|title=Problem Solving in Emergency Radiology|last=Mirvis|first=Stuart E.|last2=Soto|first2=Jorge A.|last3=Shanmuganathan|first3=Kathirkamanathan|last4=Yu|first4=Joseph|last5=Kubal|first5=Wayne S.|date=2014-08-19|publisher=Elsevier Health Sciences|page=442|isbn=9781455758395|language=en}} 20. ^1 {{Cite journal|title=Cirrhosis: Practice Essentials, Overview, Epidemiology|url=http://emedicine.medscape.com/article/185856-overview#a12|date=2018-10-31}} 21. ^{{Cite web|url=http://patient.info/doctor/non-hodgkins-lymphoma-pro|title=Non-Hodgkin's Lymphoma {{!}} Doctor {{!}} Patient|website=Patient|language=en-GB|access-date=2016-03-11}} 22. ^{{Cite web|url=https://www.nlm.nih.gov/medlineplus/ency/article/000282.htm|title=Primary biliary cirrhosis: MedlinePlus Medical Encyclopedia|website=www.nlm.nih.gov|access-date=2016-03-12}} Further reading
External links{{Medical resources| ICD10 = {{ICD10|R|16|.0|r|16}} | ICD9 = {{ICD9|789.1}} | MedlinePlus = 003275 }}
2 : Hepatology|Symptoms and signs: Digestive system and abdomen |
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