Pathological processes in the body are often accompanied by an increase in liver size. Often the cause of this phenomenon are infections and inflammatory processes. In conclusion, doctors write "hepatomegaly", what is it - do not always explain to patients.
Hepatomegaly - what is it?
Seeing among the conclusions a similar term, what is hepatomegaly - the patients are trying to find out from the attending physician. This term is usually used to refer to the change in the size of the liver the larger side. This process is often accompanied by diffuse changes in the tissue of the organ. At the same time, the liver itself can be easily probed in the area of the hypochondrium (normally this is impossible).
Hepatomegaly is not considered as a separate disease, but is only a manifestation or sign of a pathological process in the body. It is worth noting that the liver consists of two parts, so doctors can indicate which of them is affected - left or right. The exact dimensions can be determined by ultrasound. Normally the right lobe has a size of 12 cm, and the left one - 7 cm. The excess of these values is called hepatomegaly.
Hepatomegaly - Causes
When there is an increase in the liver, the reasons for which are not clear to the doctor, a comprehensive examination is prescribed. It is based on hardware methods, which are supplemented by laboratory research. Among the main factors provoking a change in the size of the liver, doctors call:
- Direct liver disease - cirrhosis , hepatitis , toxic items, alcoholic liver disease. In such cases, the body first swells, becomes inflamed. However, with the progression of pathology, the death of hepatocyte cells occurs. After that, the organ assumes its former dimensions for a while, but then the fibrotic replacement of the dead cells of the voids formed on the spot occurs. Collagenous tissue grows rapidly, which causes a repeated enlargement of the liver.
- Congenital disorders of metabolic processes - glycogenesis, hemochromatosis. At the first disease there is a violation of glycogen synthesis, which is characterized by a failure in the assimilation of iron. As a result, the microelement accumulates in the parenchyma and leads to its swelling.
- Diseases of the cardiovascular system. With such violations, venous congestion in the liver is observed, as a result of which the organ becomes edematous.
Among the reasons are also:
- fatty degeneration;
- the appearance of metastases in the organ in tumorous processes;
- occlusion of hepatic veins;
- violation of metabolic processes;
- administration of toxins.
Partial hepatomegaly
Having dealt with the causes of such a violation as hepatomegaly, what is it, it is necessary to isolate its individual types. The diagnosis of partial hepatomegaly of the liver is exhibited when an ultrasound scan showed an uneven increase in the organ. Changes affect only certain areas or shares. For example, hepatomegaly of the right lobe of the liver can often be replaced by the term "partial increase" of the organ. Suspect a violation of the doctor can with palpation - probed uneven, bumpy surface of the enlarged organ.
However, the final diagnosis is made based on the data of the ultrasound . When partial hepatomegaly develops (which is the one discussed above), the main echo of its presence is the disruption of tissue homogeneity. With a detailed examination, cysts, abscesses, and tumors can be detected, which are direct evidence of partial changes in the gland, a sign of the progression of the pathological process.
Diffuse enlargement of the liver
The increase in liver size to 12-13 cm in an adult is denoted by the term "diffuse hepatomegaly". In this case, changes can be observed in any structure of the organ: the left or right lobe, the blood supply system, the bile ducts. Diffuse changes can occur in any of these structures of the body. To the development of this type of pathology, infectious agents are most often used, such as staphylococcus and streptococcus. The main manifestation of the pathology is aching pain in the right side, giving to the subscapular region and hand.
Hepatomegaly by the type of hepatosis
In some cases, the increase in the liver occurs as a type of fatty hepatosis. For this form of the disease is characterized by the degeneration of liver cells into fat. The disorder occurs when a large number of simple fats accumulate in the hepatocytes. Pathology is the result of prolonged consumption of fatty foods, and can also arise from the use of medicines.
Normally, all toxins that enter the body pass through the liver, are neutralized to simple fats. However, due to the fact that a large amount of fatty food enters the body, excess fat begins to accumulate in the cells of hepatocytes, leading to the development of hepatomegaly. The disease has a slow course. Of particular concern to doctors is the high risk of the degeneration of these cells. The lack of proper therapy for fatty hepatosis is fraught with the development of cirrhosis and liver fibrosis.
Liver enlargement - symptoms
The signs of hepatomegaly are hidden at the initial stage. A slight increase in the organ may remain unnoticed for a long time. In addition, the symptoms of hepatomegaly (what is it - described above) are often due to pathology, which led to an increase in the size of the organ (hepatomegaly and what is it). With a pronounced clinic, the disorder can be detected by palpation, by the shape of the abdomen. For initial diagnosis, doctors use palpation (probing) and percussion (tapping). However, moderate liver enlargement by such methods is difficult to diagnose.
When interviewing a patient, collecting an anamnesis, doctors pay attention to the presence of the following possible symptoms of hepatomegaly:
- Painful sensations, the feeling of a foreign object, a lump in the right side, which are amplified by changing the position of the body.
- Appearance of skin rashes in the form of asterisks, itching.
- Accumulation of fluid in the abdominal cavity.
- Yellowing of the skin (more often with hepatitis).
- Disturbance of digestive processes ( constipation ).
- A sudden sudden increase in the size of the abdomen.
- Constant heartburn and the appearance of bad breath.
- Nausea.
Moderate hepatomegaly
A slight increase in the liver can be diagnosed only with the help of an ultrasound machine. Moderate hepatomegaly is often asymptomatic, and the existing signs of impairment are inextricably linked to the clinical picture of the disease, against which the liver has increased. A similar form of the disease is diagnosed in people who abuse alcoholic beverages. The main complaint is pain in the right hypochondrium of a non-permanent character. Other signs of moderate hepatomegaly are often absent. The diagnosis is based on the results of ultrasound and CT.
Pronounced hepatomegaly
The expressed form of hepatomegaly is a sign of pathological, but still reversible changes in liver size. This is fixed for violations such as hemoblastosis, leukemia, in which there is a strong infiltration of liver tissue by malignant cells. As a result of such changes, foci of proliferation of connective tissue, foci of necrosis. The liver reaches a large size, occupying a large volume in the abdominal cavity.
Signs of augmentation of the liver are visible and with the naked eye: the stomach becomes large, uneven. The increase is more pronounced on the right side. With severe hepatomegaly on ultrasound, doctors assess:
- the size of the organ;
- structure;
- contours of the liver.
Echo signs of hepatomegaly
When examining the organs of the abdominal cavity, carrying out ultrasound, the doctor immediately sees an increase in the liver. At the same time pay attention to the echoes of the pathology, which reflect the possible cause of the disorder. When hepatomegaly is a consequence of acute hepatitis, parasitic diseases, the liver echostructure has a uniform pattern. With fatty hepatosis, cirrhosis, chronic form of hepatitis, the ehostruktura is heterogeneous: the foci of compaction, tuberosity, violation of contours and outline of the organ, changes in its shape are fixed.
Hepatomegaly - what tests should I take?
The presence of symptoms of a possible increase in the liver is an indication for further examination of the patient. Thus, moderate liver hepatomegaly can be confirmed on the basis of the results:
- biochemical blood test (thymol test, bilirubin , ALT, AST, total protein);
- computed tomography of the abdominal cavity;
- radiography;
- analyzes of liver function tests, blood clotting tests.
Hepatomegaly - how to treat?
At the conclusion of "hepatomegaly" treatment is made individually, according to the reason of the violation. Therapy is aimed at the complete elimination of the pathological factor and the fight against clinical manifestations. The complex treatment of hepatomegaly includes:
- decreased physical activity;
- hepatoprotective therapy;
- adherence to a special diet.
Hepatomegaly - what medicines to take?
Any drugs with augmentation of the liver should be selected strictly individually and only by a doctor. The basis of drug treatment of hepatomegaly is hepatoprotectors. Among the known drugs of this group:
- Brentzialle forte;
- Lipostabil;
- Resalute Pro;
- Essentiale;
- Phosphogliv .
When hepatomegaly is caused by exposure to toxins on the body, doctors prescribe detoxification agents:
- salt and protein solutions (sodium chloride, Regidron);
- components of blood (plasma).
If the liver is enlarged due to an infection, antibacterial therapy is prescribed:
- Rifampicin;
- Neomycin;
- Metronidazole;
- Vancomycin.
As an additional means to maintain the body's defenses, immunomodulators and immunostimulants are used:
- Interferon;
- Immunomax;
- Immunal.
Liver enlargement - treatment with folk remedies
When there is an increase in the liver, the treatment should be carried out exclusively under the supervision of the doctor, according to his prescriptions. As a supplement to the basic therapy, physicians are allowed to use folk remedies. Effective in hepatomegaly are:
Herbal Remedies
Ingredients:
- Leonurus - 1 teaspoon;
- sage - 1 teaspoon;
- roots of dandelion - 1 teaspoon;
- peony - 1 teaspoon;
- water - 500 ml.
Preparation, application
- Herbs are mixed, poured with water and put on fire.
- Bring to a boil and simmer over low heat for 15 minutes.
- Decoction wrap and insist for 3 hours.
- Filter and take during the day instead of drinking.
Honey Drink
Ingredients:
- honey - 2 tsp;
- lemon juice - 2 tsp.
- water - 200 ml.
Preparation, application
- All carefully mixed.
- Take 2 times a day, morning and evening.
Hepatomegaly - diet
Telling patients about the diagnosis of hepatomegaly, what it is, doctors note the need to revise the diet. Diet with increased liver suggests a reduction in the diet of fats and heavy for digestion of food. It provides five meals with a restriction in the choice of products. When the liver is enlarged:
- vegetable oils;
- low-fat fish;
- vegetables, greens, fruits;
- cereals;
- poultry meat, beef;
- soups.
A feature of nutrition in hepatomegaly is compliance with the regime, especially in the evening. Dinner should take place no later than 7 pm, and the interval between meals during the day should be 2.5-3 hours. It is necessary to exclude from the diet:
- butter;
- margarine;
- eggs (not more than two per week);
- sausages;
- fatty cheeses;
- beans;
- bow;
- pickled vegetables;
- fried food;
- tomato juice;
- confectionery;
- chocolate.