Causes of hepatomegaly in children and how to diagnose

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor II Cao Thi Thanh - Pediatrician - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital. Dr. Thanh has worked for 25 years in the treatment of neonatal pediatric diseases.
Hepatomegaly is an increase in the size of the liver inside the abdomen; hepatomegaly is not usually an isolated sign in a patient. Therefore, timely diagnosis of hepatomegaly in children has a decisive role in the correct treatment regimen and the right disease. Thereby helping to limit other dangerous complications, affecting the health of children.

1. What is hepatomegaly?

The liver is an organ involved in digestion as well as performing many other functions in the body, including producing bile to help digest food in the stomach into energy. At the same time, it also produces necessary substances such as hormones, cleans toxins from the blood (including toxins) and controls, produces and metabolizes fats in the body.
Hepatomegaly is an increase in the size of the liver. In some cases, both the liver and spleen are enlarged, which is called hepatosplenomegaly.
Enlarged liver is a sign and symptom of a disease is a disease. It may be due to liver disease, congestive heart failure or cancer causing hepatomegaly. The mainstay of treatment is to identify the cause of the enlarged liver and control the underlying causes of the condition.

See more: What medical technique is an enlarged liver diagnosed by?

2. Causes of hepatomegaly in children

There are many causes of an enlarged liver in children. Depending on the cause, how this condition affects the child's health. Here are some causes of hepatomegaly in infants and children. Specifically:
Infections that cause hepatomegaly in children: Some viruses: such as hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E, CMV, viruses herpes simplex Hepatitis caused by bacteria such as sepsis, Leptospirose, syphilis Or caused by parasites of Malaria, Toxoplasma, Histoplasma, helminths... And caused by fungi Actinomyces, Cryptococcosis... Constrictive pericarditis , Hepatic vein thrombosis, Budd - Chiari syndrome, superior vena cava obstruction or venous network in the liver... are also some of the causes of hepatomegaly in young children. Heart failure: If heart failure, it will cause circulation problems as well as increase pressure on the portal vein, because the portal vein is the vein that supplies blood to the liver. Hematologic disease causing hepatomegaly: Hemolytic anemia of various causes (extramedullary hematopoiesis) can cause hepatomegaly in young children. Liver cancer: If it originates in the liver, it is called primary liver cancer. When cancer reaches the liver from other organs in the human body, it is called secondary liver cancer. Both primary and secondary liver cancer cause an enlarged liver. Metabolic diseases: Diseases such as Wilson's disease, glycogen storage disease, alpha-1 antitrypsin deficiency, mucolipidosis or mucopolysaccharide can all cause hepatomegaly in infants and young children. Enlarged liver due to anatomical abnormalities: Anatomical abnormalities such as biliary atresia, common bile duct cysts, gallstones ... are the causes leading to hepatomegaly. Liver injury causes hematoma or toxic hepatitis due to Acetaminophen, Fe, Vit A, toxic substances... Children with fatty liver may be due to malnutrition or vitamin deficiency causing hepatomegaly.

3. How to diagnose an enlarged liver in children?

Hepatomegaly is an increase in the size of the liver inside the abdomen; hepatomegaly is not usually an isolated sign in a patient. Therefore, timely diagnosis of hepatomegaly in children has a decisive role in the correct treatment regimen and the right disease. Thereby helping to limit other dangerous complications, affecting the health of children. The methods of diagnosing hepatomegaly in children are as follows:
Diagnosis of hepatomegaly in children is based on clinical manifestations:
Children have signs of abdominal pain, dull pain in the upper right half of the abdomen. Young children may cry, while older children may complain of pain. Children often lose their appetite, do not eat well, which leads to fatigue. Muscle aches; Jaundice and yellowing of the conjunctiva of the eyes The child's urine is dark yellow with pale stools Presence of bleeding under the skin and bleeding gums Diagnosis of hepatomegaly in children is based on tests:
For Wilson's disease: Quantification of copper/blood and ceruloplasmin/blood to diagnose hepatomegaly in young children. In case of suspected infection: It is necessary to do tests such as blood culture, hematology, CRP, diagnostic serum depending on the cause. Biliary obstruction: Signs of increased Bilirubin, PAL, gamma GT... Extramedullary hematopoiesis: Using blood tests, red blood cell shape, red blood cell enzymes, bilirubin... If blood clotting time is prolonged, An increase in NH3 / blood but a decrease in the albumin / blood index may be a sign of liver failure. The presence of signs of increased ALT and AST may be a sign of acute hepatocellular injury... Enlarged liver in young children can be caused by serious medical conditions, so if left untreated Timely and correct treatment can lead to serious complications such as: hepatic encephalopathy, liver failure, metastatic cancer or widespread infection.

Infants and young children are generally susceptible to respiratory diseases, respiratory infections and gastrointestinal infections if they are introduced to solid foods early or are not properly stored and prepared. To protect children's health, parents should do well to exclusively breastfeed their babies for the first 6 months (if possible) and vaccinate on schedule. As soon as you see a child showing symptoms such as anorexia, fatigue, crying, and especially an enlarged liver, it is necessary to take the child to the hospital to be consulted by a specialist for monitoring and treatment. The pediatric department at Vinmec International General Hospital is the address for receiving and examining diseases that infants and young children are susceptible to: viral fever, bacterial fever, otitis media, pneumonia in children. With a system of facilities, modern medical equipment, sterile space, minimizing the impact as well as the risk of disease spread, Vinmec will bring satisfaction to customers. and is highly appreciated by industry experts with:
Gathering a team of leading pediatricians: including leading experts with high professional qualifications (professors, associate professors, doctors, Master's degree), experienced, worked at major hospitals such as Bach Mai, 108.. The doctors are all well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. Advanced techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in pediatrics more effective: neurosurgery - skull, stem cell transplant blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to play comfortably and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.

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