Hepatomegaly (liver hypertrophy)

Hepatomegaly (liver hypertrophy)

    * Introduction
    * Causes
    * Signs and symptoms
    * Diagnosis
Hepatomegalism palpatoriu defines when the lower edge of the liver is located less than 2 cm reborcul rib or edge when percutoriu liver ultrasound exceeds 14 cm or when the line medioclaviculare longitudinal diameter greater than 15 cm. Hepatomegaly is not a disease in itself, but it is a cardinal sign, but met both in liver and extrahepatic disease. Descent Hepatomegalism be differentiated from the diaphragm in emphysema, abscess subfrenic or presence of abnormal-Riedel lobe, often in women. Hepatomegaly may be diffuse or circumscribed, as implied throughout the liver parenchyma or only its parts. Topography of normal liver: Right-side upper lobe is located 1 cm below the right nipple or 2 cm medial to the rib line will medioclaviculara Left-side upper lobe is situated 2 cm below the left nipple line or medio-claviculara upper edge of the sixth rib Bottom-side has a diagonal direction upwards from the coast right ninth rib cartilage in the eighth off and the right nipple line, the bottom edge is 2 cm below the costal rebordul and midline passes Appendix midway between xiphoid and umbilicus, left lobe extends about 5 cm to the left of the breastbone. Hepatomegaly Treatment varies depending on underlying disease.
Pathogenesis
Cell replication Hepatomegaly may be due to a rare, hepatocyte replication by an extensive necrosis after excessive hyperplasia or after partial liver resection. In hematological systemic diseases, hepatomegaly occurs because the liver is one of the premises of extramedullary haematopoiesis. An increase in the volume of liver may occur limfohistiocitare cell infiltration as a result of bacterial or viral infections.
Broaden the cellular structures Increasing the volume of hepatocytes and sinusoidal cells may be due either by increasing the cellular structures (Kupffer cells, endoplasmic reticulum) or by storage of substances (fat, glycogen, cholesterol, iron, copper, protein, mucopolysaccharides).
Broaden the extracellular space Blood stasis in sinusoids and space of Diss, commonly found in right ventricular failure, tricuspid insufficiency (hepatomegaly throbbing), RDS. Budd-Chiari, veno-occlusive disease, constrictive pericarditis cause hepatomegaly. Inflammatory hyperemia of acute viral hepatitis induced liver size increased. Shortage of training and associated lymph drainage of bile or hepatomegaly. Increasing the volume of extracellular matrix by production of proteoglycans, collagen, elastin, may be manifested by hepatomegaly.
Replacement processes confined space Any replacement back process, such as hydatid cyst, solitary or polycystic disease, benign or malignant tumors, causes hepatomegaly.