Hepatomegaly is enlargement of the liver. The most common causes in the UK are cirrhosis, cardiac failure and secondary malignancy. Predisposing factors include a history of contact with hepatitis, blood transfusion, drug abuse, homosexuals, haemophiliacs, health workers, the institutionalised (e.g. homes, prison) and travel abroad to endemic areas. Amoebiasis occurs worldwide, and hepatitis B is prevalent in the tropics and Mediterranean areas. Hydatid disease is more common in sheep-rearing countries, e.g. Australia, Africa, Wales. Leptospirosis can result from swimming in rat-infested waters. History of alcohol abuse predisposes to alcoholic cirrhosis. Chronic active hepatitis should be considered with a history of alcohol, hepatitis B or hepatitis C. In the majority of hepatitis/infection cases, the patient presents with general malaise, pyrexia, weight loss and jaundice. History of congestive cardiac failure may be evident and the patient often complains of upper abdominal pain caused by a tender liver due to stretching of the liver capsule. With constrictive pericarditis, there is often a history of TB but it may follow any cause of pericarditis, e.g. acute renal failure. Budd–Chiari syndrome is hepatic vein thrombosis. A history of taking the contraceptive pill may be contributory. Tumour may also cause Budd–Chiari syndrome. It presents insidiously with portal hypertension, jaundice and cirrhosis.
Hepatomegaly
Causes
History
Hepatitis/infection
Congestion
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
Basicmedical Key
Fastest Basicmedical Insight Engine
