Enlarged liver. Symptoms and treatment of liver hepatomegaly.

Mark Anatolyevich, what could be the reason for liver enlargement?

- In general, liver enlargement itself is just a symptom of the disease. It is necessary to first find out the cause of the disease, and then eliminate it.

Diseases that contribute to liver enlargement are cirrhosis and fatty hepatosis (fatty liver).

These diseases are chronic and are caused by various factors, including malnutrition, alcohol abuse, or infectious viral hepatitis.

General information

Pathological enlargement of the liver in medicine is called hepatomegaly .
This condition develops in many liver diseases, as well as in diseases of other organs and systems, chronic infections, parasite infection, tumor infiltration, etc. In liver diseases, this symptom is most often observed. In some cases, the liver can reach very large sizes and weigh more than 10 kg. However, when talking about what hepatomegaly is, it should be taken into account that an enlarged liver may indicate many pathological processes. Accordingly, the diagnosis of hepatomegaly means that the doctor must determine the underlying causes of this condition and provide adequate treatment. ICD diseases - K76 (other liver diseases). Why a person develops hepatomegaly, how this condition is treated, and what to do to prevent it will be discussed in this article.

How is diagnosis carried out?

The above reasons for the increase in liver size indicate the difficulty of finding the underlying disease and the importance of differential diagnosis. This means that, in addition to identifying hepatomegaly, all possible types of research are used: blood and urine tests, general tests, bilirubin, sugar, protein, liver function testing using biochemical tests for basic enzymes.

Monitoring of the blood coagulation system and enzyme immunoassay are prescribed for viral and bacterial infections. The doctor determines the estimated growth of the organ using percussion and palpation methods.

Hardware methods are much more accurate and objective: ultrasound, computed tomography and magnetic resonance imaging, radiography is less informative, scanning with preliminary administration of hepatotropic radioactive substances gives a complete picture of cell damage, and the proportion of remaining undamaged tissue can be calculated.

Modern equipment makes it possible to detect not only changes in size, but also to accurately contrast the boundaries, tissue structure, and the nature of the changes (focal, diffuse). Morphological changes can be definitively judged by examining a biopsy.

The most accessible method for the population is ultrasound; it is based on the principle of recording the reflection of a wave from a dense organ.

Ultrasound allows you to compare the structure of the liver in all zones, identify denser foci and the size of the lobes. Echoscopic observation can be thought of as a visual examination on a screen without recording. It is more important when monitoring a contracting organ (heart). The liver is examined using echographic criteria, and images are printed in different projections.

Pathogenesis

Speaking about the pathogenesis of this condition, experts consider several possible options for its development. In this case, either a true enlargement of the liver may occur due to damage to the vascular bed, a neoplastic or infectious process, or other changes - intoxication, degenerative, traumatic, endocrine, autoimmune. Changes can also occur at the anatomical level.

With the development of pathological processes, the liver increases in size and its structure becomes denser. In hepatosis, the process is caused by dystrophic changes in the liver cells, in acute hepatitis - by lymphomacrophage infiltration. If cirrhosis , nodes form in the liver and fibrosis occurs. If the veins of the liver are affected or heart failure , the enlargement of the organ is associated with blood stagnation. With tumors and abscesses focal changes occur.

How does hepatomegaly syndrome manifest?

During examination, the doctor identifies signs of hepatomegaly and interprets them in favor of one or another diagnosis. For example,

• the “stony” consistency of the edge of the liver, the bumpiness of the surface indicate the likelihood of cirrhosis or a tumor (new cells grow faster, so bumps form);
• pain on palpation is more typical for hepatitis (inflammation), moderate sensitivity of the edge is observed with steatosis;
• rapid enlargement of the organ is typical for the development of cardiac decompensation, with the capsule stretching, which is accompanied by pain;
• The course of liver abscess and hydatid cyst is distinguished by severe pain.

Pain in the liver area

With a significant enlargement of the liver, the patient experiences the following symptoms of hepatomegaly:

• heaviness, constant bursting pain under the ribs on the right or in the epigastrium, radiating to the side, right side of the abdomen, intensifying with movements;
• an increase in abdominal volume due to the accumulation of fluid in the abdominal cavity (ascites);
• itchy skin rashes;
• yellowing of the sclera and skin;
• nausea, heartburn;
• bowel dysfunction (alternating diarrhea and constipation);
• small angiomas on the skin of the face, chest, abdomen in the form of “spiders” or spider veins.

Jaundice is one of the possible symptoms of pathology

Specific symptoms depend on the cause of hepatomegaly. With hepatitis, the patient's liver enlarges evenly, a thickening appears, which is felt along the lower edge. Palpation is painful. There is yellowness of the skin, signs of general intoxication and inflammation (fever, weakness, headaches, dizziness).

Treatment of hepatomegaly caused by viral hepatitis requires antiviral agents and immunostimulants. With good efficiency, the liver returns to normal size. Cirrhosis differs from hepatitis in the mechanism of destruction of liver tissue. Due to diffuse changes in the liver with areas of necrosis, working hepatocytes are replaced by scar tissue.

Impaired functions are accompanied by a tendency to bleeding, the skin takes on an earthy tint, and ascites grows due to portal hypertension. An expanded venous ring with outgoing vessels in the form of a “jellyfish head” appears around the navel.

In metabolic disorders characteristic of metabolic diseases, fermentopathy, along with hepatomegaly, the following is detected:

• damage to the kidneys and spleen (glycogenosis);
• copper deposits and a colored ring around the iris, hand tremors (Wilson-Konovalov disease);
• yellow-brown spots on the body and xanthelasmas on the eyelids, the connection of clinical manifestations with a period of fasting (pigmented hepatosis in Gilbert's syndrome);
• cough with hemoptysis (hemochromatosis).

In the patient, the signs of heart disease come first: shortness of breath, swelling in the legs, ascites, palpitations and arrhythmia, angina-type pain, cyanosis of the feet, hands, lips, and in children - the nasolabial triangle.

Classification

When making a diagnosis, the condition is classified from an anatomical and morphological point of view. The following types of damage are distinguished:

• bile ducts;
• parenchyma;
• connective tissue;
• vascular network.

In addition, during the diagnostic process it is noted whether hepatomegaly is combined with jaundice , enlarged spleen or ascites .

Hepatosplenomegaly is an enlargement of the liver and spleen. This condition can occur in a number of diseases and conditions. These are liver diseases, infectious and parasitic diseases, metabolic diseases, etc. Since an enlarged liver and spleen is a typical manifestation of many diseases, it is very important to promptly identify this condition and conduct additional examinations.

Taking into account the degree of liver enlargement, the following types of hepatomegaly are distinguished:

• Moderate – the size and structure are slightly changed. Moderate hepatomegaly is the easiest to treat.
• Pronounced - the organ is enlarged by 10 cm relative to the norm.
• Diffuse – an increase of more than 10 cm.

Partial hepatomegaly is distinguished separately, which is characterized by an uneven increase - the process affects only a part or one lobe.

Depending on the reasons for the development of such a pathological process, the following forms are distinguished:

• Drug injury – develops as a side effect when using certain medications.
• Toxic damage - occurs as a result of the influence of toxins - household (polluted air), natural (consumption of poisonous mushrooms), industrial (work in hazardous enterprises).
• Alcoholism is a very common form. fatty liver , alcoholic hepatitis , fibrosis , and cirrhosis can develop .
• Viral infection - occurs due to infection with hepatitis B and C.
• Infectious lesions - characteristic of mononucleosis , hepatitis A.
• Immune damage is a consequence of malfunctions in the immune system, when antibodies “erroneously” act on the liver.
• Cancerous lesion is a consequence of oncological processes. It can develop with ineffective treatment of hepatitis and cirrhosis .
• Dystrophic damage is a consequence of changes in the volume of liver cells and the accumulation of fat in them. This type of injury is called hepatic coma and can be fatal.

What is the treatment?

— One of the most common causes of liver disease is viral hepatitis. In this case, antiviral therapy is prescribed.

If it is toxic, alcoholic hepatitis, then you need abstinence from alcohol, medication support and diet.

In case of fatty hepatosis associated with excess body weight, measures aimed at reducing excess body weight, diet, drug treatment, and surgical intervention if necessary are prescribed.

In the case of cirrhosis, that is, more severe liver damage, treatment is more difficult, but it is possible. First of all, therapy is aimed at eliminating the causes of cirrhosis.

The next step will be treatment with various medications that allow the liver to function more optimally. Well, the last resort treatment for cirrhosis is liver transplantation.

Causes of liver enlargement

Liver enlargement can be caused by various reasons. In adults and children, this organ may enlarge due to the influence of one or more factors.

Most often, the causes of enlargement of the left lobe of the liver or the right lobe are associated with the following diseases and conditions:

• Neoplastic processes - the development of tumors, mainly metastatic, as well as hemangiomas or adenomas .
• Disturbances in the vascular bed - the hepatic and portal veins can be affected due to the formation of a blood clot. Also, such disorders may be a consequence of pathology of the hepatic artery, Budd-Chiari syndrome .
• Degenerative lesions - non-alcoholic steatohepatitis , steatohepatosis .
• The influence of substances toxic to the liver - alcohol abuse, taking medications.
• Infectious viral processes - infectious mononucleosis , viral hepatitis , nonspecific cholangitis , etc.
• Autoimmune diseases.
• Amyloidosis.
• Endocrine disorders.
• Congenital pathologies.
• Injuries.

In addition, experts identify some factors that increase the likelihood of developing hepatomegaly:

• Regular alcohol abuse.
• Long-term use of high doses of medications, vitamins, biological additives.
• Excess weight , unhealthy and irrational nutrition.

3.Causes of the disease

The causes of liver enlargement can be very different.

Inflammation or fatty liver can cause hepatomegaly, and it occurs as a result of factors such as:

• Infections due to a virus or abscess;
• Some medications;
• Toxins;
• Some types of hepatitis, including alcoholic hepatitis;
• Autoimmune diseases;
• Metabolic syndrome;
• Genetic disorders.

Liver enlargement can occur due to the growth of abnormal formations, including:

• Cysts;
• Tumors that begin to grow or spread into the liver.

Problems with blood flow are another possible cause of liver enlargement.

Various conditions can lead to this, including:

• Chronic heart failure, in which the heart cannot pump blood as well as it should;
• Vein thrombosis in the liver, blockage of veins in the liver;
• Veno-occlusive endarteritis, blockage of small veins in the liver.

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Symptoms of liver enlargement

Signs of hepatomegaly are associated primarily with true enlargement of the liver. It is diagnosed if the size of the organ along the right midclavicular line is more than 12 cm, or its left lobe is palpated in the epigastric region. In normal condition, the liver is soft and can be easily felt under the ribs.

It is also important to take into account the fact that there are no nerve endings in the liver, so even with the development of pathological processes, symptoms may not appear. Often, in the initial stages, adults periodically experience only minor discomfort or pain at the location of the organ. Only during an ultrasound examination can characteristic echo signs be determined.

Symptoms of liver enlargement

Consequently, signs of liver enlargement in adults, and sometimes in children, are often diagnosed already in the later stages, when the pathological process is already actively developing. Then a more pronounced clinical picture is observed. If the liver is enlarged by 2 cm or more, the following signs may be observed as the pathological process develops:

• Discomfortable sensations in the area of ​​the right hypochondrium. They may worsen after eating and physical exertion.
• A feeling of heaviness after consuming a small amount of water or food.
• Periodic heartburn .
• Belching with an unpleasant odor.
• Disorders of the digestive system - constipation , diarrhea , nausea, periodic vomiting. Possible vomiting of bile.
• Discolored stool that may contain particles of undigested food.
• Yellowness of the skin and mucous membranes, yellowness of the sclera of the eyes. The skin may also take on a sallow tone.
• Itchy skin.
• Sudden mood swings, irritability.
• Drowsiness or insomnia .
• Tachycardia.
• Heavy sweating.
• High blood pressure .
• Pain in the chest area, feeling of tightness.
• When palpating the liver at a doctor's appointment, a person may feel pain.

How does hepatomegaly occur in pregnant women?

Doctors note that liver problems during pregnancy occur in the third trimester. An enlarged uterus displaces the liver upward to the right. The movements of the diaphragm are limited, which makes it difficult to remove bile and fills the liver with blood.

Hormones influence the functioning of the liver, which is manifested by yellowish spots on a woman’s face and “stars” on the skin. An increase in fatty acids, cholesterol, and triglycerides is detected in the blood of a pregnant woman.

Pathological hepatomegaly can be caused by:

• toxicosis with prolonged vomiting, observed in 2% of pregnant women from the fourth to the tenth week, stops by the twentieth week, due to vomiting, dehydration, electrolyte disturbances can occur, and the woman’s weight decreases;
• intrahepatic stagnation of bile, found in every fifth pregnant woman, the cause is associated with hereditary predisposition.

Hepatomegaly can occur during pregnancy due to exacerbation of existing chronic diseases (heart decompensation, fatty hepatosis, diabetes mellitus, neoplasms, leukemia, hepatitis)

Tests and diagnostics

To determine the presence of hepatomegaly and the causes of such manifestations, the examination is carried out according to the following scheme:

• The doctor conducts a detailed survey of the patient about complaints and examines the medical history.
• Next, palpation is performed to determine the size, boundaries and density of the liver.
• It is important to determine the results of a general and biochemical blood test. Using the data obtained, it is possible to determine the presence of infectious and inflammatory processes and assess the level of liver enzymes . A general urine test is also performed.
• Markers of viral hepatitis are determined.
• An ultrasound of the liver is performed. This is a fairly informative method that allows you to determine the condition of the liver, portal vein, and hepatic artery.
• Informative studies are CT and MRI.
• If necessary, the doctor prescribes a laparoscopic examination.
• According to indications, a puncture is performed and material is taken for a biopsy .

In the normal state of the organ, its length is 14-20 cm, its cross-sectional size is 20-22.5 cm, in the sagittal plane - 9-12 cm. The length of the right lobe is 11-15 cm, the thickness of the left lobe is approximately 6 cm, and its height is less than 10 cm. Deviations can be no more than 1.5 cm.

Hepatomegaly is diagnosed if the size of the organ exceeds 12 cm or an increase in the left lobe of the liver is noted (in this case it is palpated in the epigastric region). During the diagnostic process, liver prolapse and the location of other tissues in the right upper quadrant (this could be tumors, an enlarged gallbladder) are also excluded.

Obesity... of the liver: what is dangerous about steatohepatosis and how to live with this diagnosis?

Our expert:

Evgeniy Ivanovich SAS

gastroenterologist, hepatologist, doctor of medical sciences, professor, leading researcher at the research center of the St. Petersburg State Pediatric Medical University

– Evgeny Ivanovich, let’s start the conversation with a clear definition of the diagnosis. There are names “fatty hepatosis”, “fatty liver”, “non-alcoholic fatty liver disease” (NAFLD), “steatohepatosis”. Do all these terms refer to the same disease or different ones?

- Yes and no. At first glance (we often see this in publications) these are different names for the same disease. Let's say that we have a patient with diabetes or obesity. In this case, the diagnosis “non-alcoholic fatty liver disease” (NAFLD) would sound more correct, which reflects that metabolic disorders play a major role in the development of the pathology. When the cause is not yet known (it could be drug, toxic or alcohol-induced liver damage), we use the terms “fatty liver disease”, “fatty liver” or “steatohepatosis”.

– What are the symptoms and signs of fatty liver disease? How long can the disease develop asymptomatically, because, as you know, the liver is one of the most “silent” organs; it does not “report” its unfavorable condition until the onset of a very serious condition...

– Symptoms of fatty liver disease are truly nonspecific. These are increased fatigue, daytime sleepiness, insomnia at night, and so on. Many have already recognized themselves (especially on the eve of vacation), right? However, these symptoms can be either a consequence of simple fatigue or a signal of many other diseases. The only reliable option for detecting fatty hepatosis (which has been practiced in our country for many years) is preventive examinations with a biochemical blood test and ultrasound examination of the abdominal organs - a kind of “technical examination of the body.”

– What happens in the liver during fatty hepatosis? Do I understand correctly that functional cells - hepatocytes are replaced by adipose tissue? Is this dangerous, and if so, what is this danger?

– Let’s imagine a librarian (or any other person) who has gained 30–50 kilograms in weight. He comes to work in the morning and must carry out his job duties: maintain a file cabinet, look for requested books (sometimes climb on a stepladder to get them), arrange returned books... By lunchtime it will become clear that every extra kilogram has to be worked off, and there is absolutely no strength left . Roughly the same thing happens with the liver: the cells are filled with fat, it’s difficult for them to work, but they can’t “reach out to the owner.”

– What factors contribute to the occurrence of fatty hepatosis? Which of them depend only on the patient himself and can be corrected by him?

– First of all, it is necessary to talk about the wrong way of life. Excessive consumption of sweet and fatty foods, sedentary lifestyle. Separately, I would like to say about the excessive consumption of healthy foods. In the summer, many people try to make up for what they missed during the long winter, saturate their bodies with “fresh vitamins” and begin to consume large quantities of fresh fruit (or actively feed their children with it). One kilogram of grapes, bananas, persimmons, dates, some varieties of apples and other sweet fruits contains a lot of carbohydrates and, accordingly, an amount of calories that we cannot spend during the day. This is a sure step towards obesity and fatty hepatosis. Separately, I would like to dwell on physical activity: recent studies have shown that skeletal muscles have hormonal activity, so physical education will help not only normalize metabolism, but also reduce the activity of the inflammatory process in the liver and pancreas.

– How is the diagnosis made? What tests do I need to take and what studies do I need to undergo? What should serve as a warning signal for a person to make an appointment with a hepatologist? Or do you need to check the condition of your liver periodically, even if nothing worries you?

– It is quite difficult to get to a hepatologist, and the need to visit him arises when we cannot establish the cause of fatty hepatosis or all attempts to treat it are unsuccessful. As a rule, the diagnosis is made by the “first contact” doctor – the therapist. To do this, it is necessary to perform a biochemical blood test and an ultrasound examination of the abdominal organs. But, I will repeat once again, in view of the importance of what has been said: the leading role in the diagnosis of fatty hepatosis is given to an annual in-depth medical examination.

– Is it correct to talk about prevention in relation to fatty hepatosis? Is it possible to prevent the occurrence and development of this disease?

– Fatty hepatosis is exactly the disease to which it is very appropriate to apply the concept of prevention. Eating enough dietary fiber (porridge, vegetables), reducing the consumption of sweets first and then fatty foods, physical activity, consuming fish oil (not in the form of cooked fatty fish, which will add a few extra centimeters to the waist, but in the form of food supplements) is an adequate prevention of fatty hepatosis.

– If the diagnosis has already been established, what changes should occur in the patient’s life? For example, do you need to adjust your diet and how severe should such dietary changes be?

– Food should be varied and sufficient. Our diet contains a huge number of foods that are low in calories and at the same time beneficial for the liver (low-fat cottage cheese, turkey, rabbit, strawberries, raspberries, etc.), which allows the patient not to feel “deprived”. I try to avoid the word “diet,” which scares off many patients, or talk about a specific period of dieting. This is a healthy lifestyle that needs to be followed from childhood. As a rule, all exotic diets combined with the use of a “miracle” product or technique are based on the basic principles of a healthy lifestyle. I would like to warn readers: a sharp restriction of calories and rapid loss of body weight may be accompanied by an increase in hepatosis at the first stage and an increase in the lithogenicity of bile (the tendency to form stones). Therefore, it is necessary to “accompany” the patient with a doctor at this stage and timely correction of these changes with ursodeoxycholic acid drugs (ursosan).

– How to treat the disease? How often should you visit a doctor? Should a patient with fatty hepatosis be registered with a hepatologist and periodically monitor the dynamics of the disease?

– The therapy is based on lifestyle modification: the use of foods with a low glycemic index, increased aerobic (walking, running, swimming, etc.) exercise, mandatory correction of intestinal microflora, as well as the use of drugs that have a hepatotropic effect (restoring liver function) . Separately, it is necessary to touch upon the correction of metabolic disorders: for patients with diabetes mellitus, this is control of sugar levels; for patients with lipid metabolism disorders – normalization of cholesterol levels. In this regard, the doctor determines on an individual basis the frequency of visits to his patient.

– What are the prognosis for the development of fatty hepatosis? Can he be completely cured? Are the changes that occur with this liver disease reversible or irreversible? Can steatohepatosis lead to serious consequences for the liver - for example, cirrhosis, cancer?

– Fatty hepatosis is reversible, so it is necessary to strive to cure it. However, with the long-term development of the disease, an inflammatory process occurs, which leads to fibrotic changes (which are already irreversible) in the liver, followed by possible cirrhotic and oncological transformation, which determines the need for early diagnosis and treatment of this disease.

Interviewed by Tatiana GOLTSMAN

Treatment with folk remedies

For hepatomegaly, any folk remedies should be used very carefully and in no case should they replace the main treatment. Before using any traditional method, you should consult your doctor about the advisability of its use. In addition, traditional methods also have certain contraindications.

• Milk thistle tea . This medicinal plant protects liver cells and promotes the regeneration of new ones. Also acts as an anti-inflammatory agent. The main active component of the plant is silymarin, which is part of a number of hepatoprotective drugs. To prepare milk thistle tea, you need 1 tsp. Pour 200 ml of boiling water over the seeds of the plant. After half an hour, strain and drink warm in two doses.
• Infusion of immortelle . The inflorescences of this plant contain a lot of flavonoids that have hepatoprotective activity. The use of products with immortelle helps restore the detoxification function of the liver. To prepare an infusion of immortelle, add 10 g of flowers to 250 ml of water and heat the container in a water bath for half an hour. After 10 minutes, strain and squeeze. Add water so that the total amount of product is 250 ml. Drink in 4 doses throughout the day.
• Rose hip decoction . Rose hips also contain many flavonoids. Rosehip helps eliminate spasms of the bile ducts, has a beneficial effect on the digestion process, and produces an anti-inflammatory effect. To prepare a decoction, add 200 g of berries to 1 liter of water, bring to a boil and cook for 15 minutes. Strain, drink 150 ml 4 times a day.
• Collection of herbs . This collection may include oregano, nettle, chamomile, calendula, centaury. Herbs should be mixed in equal proportions and an infusion should be prepared by pouring 2 tsp. mixture 250 ml water.
• Beetroot, pumpkin . These vegetables should be included in the menu more often, preparing a variety of dishes from them. Raw pumpkin is beneficial, as is freshly squeezed beet juice.

CAUSES OF HEPATOMEGALY, RISK FACTORS

The cause of the development (etiotropic factor, impetus for the occurrence) of hepatomegaly can be a variety of diseases. In clinical practice, hepatologists (the so-called specialists whose profile is focused on the management of patients with a diseased liver), as a rule, note hepatomegaly caused by the following pathologies:

• Oncological diseases of the liver - both benign and malignant. Moreover, the enlargement of the liver will most likely be uneven;
• Hepatitis of a very different nature - viral, toxic, autoimmune, alcoholic;
• Polycystic disease;
• Parasitic diseases, for example - echinococcosis (echinococcus is a worm that, when it enters the liver, forms a large cavity filled with a toxic liquid);
• Chronic infectious diseases accompanied by liver damage;
• Severe intoxication, in which the effect of toxic substances extends to the entire body;
• Liver cirrhosis (this disease in the early stages of development leads to hepatomegaly, and in the terminal stage of cirrhosis, on the contrary, the liver decreases in size).

Metabolic disorders in the body and various cardiovascular diseases can also provoke the occurrence of hepatomegaly (for example, with chronic cardiovascular failure of the 2nd stage, stagnation in the pulmonary circulation is formed, the outflow of blood from the liver is disrupted, as a result of which its size increases).

Prevention

The essence of prevention is to prevent diseases that lead to liver enlargement. To do this, it is important to follow the following recommendations:

• Eat right and do not abuse unhealthy foods, control your intake of carbohydrates and fats.
• Get rid of bad habits.
• Avoid uncontrolled use of medications, carrying out drug treatment only as prescribed by a doctor.
• Follow all hygiene rules to avoid parasitic or viral infection.
• Those who have suffered from liver disease should undergo regular preventive examinations with a doctor.
• Practice regular physical activity, but it should not be excessive.

What cases from practice related to liver disease do you remember?

— Severe liver damage occurs with viral hepatitis, when a person for a long time did not know that he had a virus, for example, hepatitis C. This hepatitis can be asymptomatic for many years, ultimately leading to cirrhosis of the liver.

That is, a person lived a normal life and suddenly he began to develop symptoms of cirrhosis. Upon further examination, it turned out that the patient’s liver functions were impaired, the disease was already at a serious stage, and the person was on his way to the operating table for a transplant. We have to fight such cirrhosis, and we are talking about survival, not about cure.

In children

Hepatomegaly in a child may be associated with neonatal jaundice. In a small child, it develops due to birth injuries, as well as dysfunction of the mother’s endocrine system. As a rule, liver enlargement in newborns does not require treatment and goes away within a month.

Minor hepatomegaly, which is determined by palpation or ultrasound in a child under 7 years of age, is also considered a physiological phenomenon. It is normal if the liver protrudes beyond the edges of the ribs by 1-2 cm. The condition, as a rule, normalizes as the child grows. However, if an increase in the right lobe of the liver or its left lobe is detected, it is better to undergo additional studies to exclude the development of diseases.

An enlargement of the left or right lobe of the liver in children may be associated with the following diseases and conditions:

• inflammatory processes;
• toxic damage;
• congenital TORCH infections;
• dysfunction of the biliary tract;
• metabolic disorders;
• tumors, metastases.

A particular cause for concern is the situation when hepatomegaly in children is combined with other alarming symptoms: fever, vomiting, rashes, weight loss, poor appetite, yellowness of the skin and mucous membranes. In this case, you should immediately consult your doctor.

Can hepatomegaly develop in only one lobe of the liver?

The liver consists of two lobes, each with its own innervation, blood supply, and bile ducts (central artery, vein, bile duct). Isolated hepatomegaly of the right lobe of the liver is observed more often than the left. Functionally, the right lobe is loaded more, performing 60% of the organ’s work, so any violations primarily affect it.

The left lobe is rarely affected; it is located closer to the pancreas; therefore, pancreatic disorders can cause an increase in the lobe

The examination usually reveals damage to the gallbladder and ducts, and the spleen.

With uneven enlargement of the organ, they speak of partial hepatomegaly. The lower edge of the liver rarely changes, so ultrasound is necessary for detection. A characteristic echo sign is a change in the homogeneity of the tissue structure. Usually found in tumors, cysts, and abscesses.

Diet

Diet for an enlarged liver (hepatomegaly)

• Efficacy: no data
• Timing: constantly
• Cost of products: 1400-1500 rubles. in Week

Diet is one of the important components of complex treatment of this condition. If the increase is insignificant, sometimes only nutritional correction can normalize the condition of the organ.

First of all, it is important to limit the amount of salt to 6-7 g per day and the amount of sugar to 50 g per day. You should drink up to 2 liters of water daily. You need to eat fractionally - up to 6 times a day in small portions.

For hepatomegaly, it is recommended to include the following foods and dishes in the diet:

• Low-fat dairy products.
• Vegetables – fresh, as well as stewed, baked and boiled.
• Lean meat, fish.
• Vegetable soups.
• Vegetable oils.
• Fruits.
• Marmalade, dried fruits, honey, biscuits.
• Cereals.
• Egg white.

The following foods should be excluded from your diet:

• Spicy, fried, salty dishes.
• Smoked meats and canned goods.
• Fatty meat and fish.
• Mushrooms.
• Egg yolk.
• Legumes.
• Sorrel, spinach, radish, onion.
• Fatty dairy products.
• Muffins, baked goods, cocoa, nuts.
• Alcohol.
• Soda, coffee, sour juices.