Hepatomegaly is a pathological syndrome consisting in
true liver enlargement (size along the right midclavicular line
exceeds 12 cm or the left lobe is palpable in the epigastric
areas). Normally soft livers, palpable
under the costal arch. In various diseases, the size of an organ can
increase significantly, the structure becomes more dense.
Что это за болезнь печени, причины и признаки гепатомегалии
in adults and how to treat it properly and why diet plays
important role in recovery.
Hepatomegaly: What is a liver disease?
Hepatomegaly is the process of increasing the size of the liver,
initiated by various painful conditions. Он может
cause diffuse or focal liver changes, but always
is pathological, since it is diseases that lead to
such a drastic change in the size of the body that for him
characteristic even in the period of increased functional load.
The liver is located under the diaphragm and consists of two lobes, its
called “natural filter” because of its ability to display
harmful substances from the body and purify the blood. In normal
condition has a smooth structure, probing does not cause
The normal parameters of an organ when examining it with
ultrasound machine in the anteroposterior direction make up
12.5 cm when measuring the right lobe and 7 cm – the left lobe. Transverse
Size is 20 – 22 cm. Value also have dimensions
vascular bundle of the liver.
An enlarged liver does not contain specific information about
disease, but serves as a clear signal that pathology
It is important to emphasize that the liver has significant
reductive reserves, so the disease can be long
develop without symptoms.
These reserves allow the body to perform its functions even with
lesion of 50% or more. Mild hepatomegaly may
persist in humans for many years.
Depending on the degree of increase in body allocate:
- moderate hepatomegaly (slight change in size and
structures that do not fit the norm),
- pronounced (an increase of 10 cm from the norm),
- diffuse (more than 10 centimeters).
A separate form is partial hepatomegaly, when
the liver increases unevenly – only part of it or one
Causes of hepatomegaly in adults
With metabolic disorders, the liver begins to accumulate
carbohydrates, fats and other metabolic products that causes it
increase. Among the diseases of accumulation can be called hemochromatosis,
amyloidosis, fatty hepatosis, hepatolentic degeneration.
Causes of metabolic disorders associated with lifestyle
human, but some of these pathologies have hereditary
All diseases of the liver lead to the defeat of its cells. Wherein
either the regeneration process starts, or tissue swelling occurs.
For edema, inflammation must be removed to return the organ to
With hepatomegaly, it is necessary to undergo a series of examinations for
finding out the reasons for its development. These may include the following
- infectious diseases;
- дистрофия жирового типа;
- intoxication with alcohol or drugs;
- supersaturated liver fatty substances;
- unhealthy diet;
- appearance of fluid metastases;
- obstruction of the veins of the body;
- pathology of metabolic processes;
- benign neoplasms;
- copper accumulation.
If metabolism is disturbed, accumulation occurs in the organ.
metabolic products, which leads to hepatomegaly. Causes of development
- fatty hepatosis.
Diseases of the cardiovascular system
This cause rarely leads to hepatomegaly in the newborn and
young children. It is most commonly diagnosed in humans.
middle or old age. The reasons for the increase in body in this
case are as follows:
- circulatory failure;
- constrictive pericarditis.
Symptoms and characteristic signs
Hepatomegaly of the liver is a pathological enlargement of the organ and
diffuse change of its tissues. With this pathology, the liver can
it is easy to palpate under the ribs, while a healthy organ
hard to probe. On palpation, the patient feels pain, which also
is a sign of disease. Hepatomegaly is a symptom
which indicates that the liver needs treatment.
The following symptoms may be of concern to the patient:
- Sore feeling or feeling of heaviness in the right side,
especially when changing the position of the body.
- Skin rash, accompanied by itching. Sometimes appear
red dots on the skin resembling spiders – with vascular
�”Legs”, diverging to the side. They are even called “hepatic
- Accumulation of fluid in the abdominal cavity.
- Digestive disorders (not only diarrhea, but also constipation).
- Increased abdominal volume.
- Frequent heartburn, joined by bad breath
The left lobe is rarely increased, mostly right. Left
the proportion is next to the pancreas, therefore increasing
This part of the liver is usually associated with disorders of the gland.
The right lobe of the liver is more susceptible to hepatomegaly. It happens
because of the greatest load that falls on her. And the growth
share can be natural, not a consequence of the disease. With
diagnosis, most of the attention is paid to the right part
liver, as it is responsible for the main load and
Symptoms of the disease depending on the cause of the lesion
|With вирусном гепатите||
|With гемахроматозе печени||
In fact, the doctor has only two approaches to diagnose
and detection of hepatomegaly:
- Manual techniques (palpation and percussion of the abdomen).
- Methods of visualization of internal organs (ultrasound, CT, MRI).
Each approach has its own advantages as well as
limitations. Therefore, to increase the accuracy of diagnosis, try
apply both approaches, with manual methods
primary, and visualization – secondary.
Symptoms characteristic of hepatomegaly give good reason for
conducting a detailed examination of the body. Usually,
patients are prescribed:
- Biochemical analysis of blood (serum bilirubin,
thymol test, alkaline phosphatase, total protein and proteinogram,
ALT and AST).
- Computed tomography and magnetic resonance imaging
- Ультразвуковое исследование органов abdominal cavity.
- Analysis of liver function, including tests for clotting
- Biopsy. In some cases, to clarify the processes in the liver,
perform a biopsy. This analysis is done using
How to treat hepatomegaly of the liver?
With увеличенной печени лечение назначается в зависимости от
diagnostic results. When hepatomegaly is caused by viral
hepatitis, then full recovery can be achieved by strictly following
instructions of the attending physician. Therapy is carried out for
certain time. After viral infection
finally eliminated from the body, it is very important not to allow
Treatment of hepatomegaly with drugs:
- Therapy of the underlying disease drugs.
Hepatitis (A, B, etc.) require the appointment of antiviral drugs.
Listeriosis and other bacterial infections are treated.
- Echinococcosis is an indication for the appointment of anthelmintic
drugs (mebendazole and others).
- Cancers require prescription
chemotherapeutic agents. Heart failure is treated
- hepatoprotectors – drugs that protect against damage
liver cells and restore already damaged hepatocytes. With this
used for the purpose: essential phospholipids, herbal preparations
origin, complexes of vitamins and amino acids.
Hepatomegaly всегда требует полного
обследования больного для уточнения диагноза.
With некоторых заболеваниях ткань печени может полностью
restore. For example, in non-severe forms of viral
Hepatitis comes full recovery, and the liver acquires its own
Chronic progressive diseases that lead to
the death of a large number of liver cells and their replacement by cells
connective tissue usually end with cirrhosis. Restore
liver function completely in this case is impossible.
For the surgical removal of the causes of hepatomegaly
- opening and drainage of liver ulcers – with purulent
- removal of tumors – with cancer. Surgical
removal of benign tumors is carried out when developing
a significant increase in the liver;
- ligation of vessels for bleeding caused by
trauma to the liver tissue.
Transplantation is indicated if hepatomegaly is caused by acute thrombosis.
Диета для людей с гепатомегалией
With гепатомегалии соблюдаются принципы лечебного питания
according to M. Pevzner. This is the so-called table number 5 – sparing diet, which
prescribed for all diseases associated with an increase in the liver and
spleen, as well as the gallbladder. Indications for its use
are acute and hepatitis, cirrhosis, gallstones.
The main principles of clinical nutrition are:
- physiological nutritional value of the diet for all
macro / micronutrients;
- gentle nutritional habits;
- regularity and fractional nature of the meal.
A diet with an enlarged liver includes the following.
- oatmeal pearl barley, vermicelli, buckwheat or rice;
- fish assortment is represented by low-fat varieties; low fat
- dairy soups with the addition of pasta, vegetables and cereals.
You can not eat first courses on
- based on rich broth;
- meat products of low-fat varieties. These can be meatballs,
cutlets or sausages. In rare cases
- cooking meat in the form of large pieces is allowed;
- protein omelet from one egg;
- vegetable variety includes carrots, zucchini, beets,
potato and pumpkin. You can add to the menu
- dishes from baked, boiled or fresh vegetables;
- dried fruits;
- oil (vegetable, cream);
- Yesterday’s pastry bakery without adding
- honey, jelly, souffle;
- decoction of wild rose.
Diet for hepatomegaly of the liver provides an exception to
dietary intake of the following foods:
- Fatty red meat, offal, waterfowl meat
poultry, oily fish, lard, confectionery, chocolate, cakes,
cakes, puff / pastry dough.
- Legumes and all coarse vegetables, sour sauerkraut, pickles and
- Culinary / animal fats, smoked meat, seafood.
- Spinach, sorrel, radish, onion, mushrooms, radish, garlic, mayonnaise,
ketchup, hot sauces horseradish, pepper, vinegar, mustard.
- Whole milk, salty / spicy cheese. Limited use
fat cottage cheese, sour cream, cream and sweet curd bars.
- Raw chicken eggs, boiled soft-boiled – up to three pieces
- Strong tea / coffee, cocoa, chocolate, ice cream.
- Alcoholic and carbonated drinks, packaged juices.
Effective folk remedies that can be used in the treatment
гепатомегалии the liver.
- Medicinal solution from honey does not favorably affect
only on the functioning of the body, but also on the liver. Every morning and
before bedtime, drink a drink of 2 spoons of honey, 200 ml of warm water and
2 spoons of lemon juice.
- Dry motherwort with sage, add dandelion root with
peony Take chicory. Mix, pour 500 ml of water. Waiting for when
boil. Cool down – half an hour. Strain and drink.
- Pumpkin. We eat, rubbed, cook porridge or juice. Maybe someone
more like raw pumpkin. And someone does want to do
- Beet. Here is another useful vegetable for the liver. And raw beets
squeeze the juice, keep it for 15–20 minutes and mix with
fresh carrot juice in a ratio of 3:10. Drink a day
100 ml of this juice. Also, beets can be put in salads or
Forecast определяется причиной синдрома и степенью повреждения
hepatocyte reversibility process. Prognostic unfavorable
hepatomegaly in liver cirrhosis, toxic damage,
primary neoplastic process. A moderate increase in organ with
common diseases, including viral infections, transient
hepatomegaly in children is characterized by rapidly regressing
Doubtful prognosis in the case of hepatomegaly is set only
patients with cancer pathology at the 2-4th stage of the process, and
also patients with genetic diseases.
The liver quickly returns to normal
size in such cases:
- viral infections;
- with the so-called transient hepatomegaly (transient
increase without laboratory changes) in childhood.