Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Case reports of benign hepatoma in young women taking oral contraceptives (OCs) are known to exist. A benign hepatic adenoma was discovered in a young woman who had been taking an OC (Ortho-Novum 2) for 7 years. Although hepatic adenoma is a rare tumor, the increasing number of reports of its occurrence strongly suggest an association between OCs and benign hepatic adenoma. Diagnosis must be suspected in any young woman taking OCs and developing signs of acute cholecystitis with hepatomegaly or mass, or presenting with signs and symptoms of nontraumatic intraabdominal hemorrage. Rupture of the tumor is life-threatening. Treatment should be removal of the tumor whenever possible.
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PMID:Benign liver cell adenoma associated with use of oral contraceptive agents. 17 59

In this case report, it is emphasized that duration of exposure to an oral contraceptive is not of prime importance. The patient was a 30-year-old woman complaining of sudden onset of severe epigastric pain which radiated to the right upper abdomen and the right shoulder. She had been using anovulatory pills for 18 months. A mass was felt in the right upper abdomen. The white cell count was 21,000/cu mm. Acute cholecystitis was the original diagnosis. In the next 4 days the bilirubin rose to 2.9 mg% and the alkaline phosphatase to 23.1 KA units. At laparotomy the gallbladder was found to be normal. Hepatomegaly was noted. A liver biopsy was taken. Subsequently a liver scan showed a large defect in the right lobe of the liver. Selective angiography of the right hepatic artery showed a large vascular mass. The diagnosis was changed to hepatic adenoma with secondary hemorrhage. Before further surgery the patient suffered a cardiorespiratory arrest and died. At autopsy a hepatic adenoma was found in the right lobe. A large embolus was found blocking the pulmonary arteries. The embolus was considered the cause of the sudden death.
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PMID:Fatal outcome of an hepatic adenoma following short term oral contraceptive use. 92 51

This paper reviews the literature reports concerning sickle cell disease and the hepatobiliary system. Sickle cell disease can cause progressive injury to the liver with significant fibrosis, often cirrhosis, and decreased liver function by adulthood. Asymptomatic patients commonly have hepatomegaly and elevated liver enzyme levels. The presence of sickle cell disease obscures features otherwise useful in differential diagnosis. Acute episodes of the disease selectively affect the liver in 10% of patients, causing hepatic crisis with abdominal pain, nausea, fever, jaundice, and transaminase elevation. Viral hepatitis is often clinically indistinguishable from hepatic crisis, but in viral hepatitis the abdominal pain is usually less, the jaundice tends to be more severe, and the transaminase elevation more prolonged. The two can be distinguished by serology and liver biopsy. Furthermore, acute cholecystitis or choledocholithiasis may have clinical and laboratory features similar to sickle cell hepatic crisis or viral hepatitis. By adulthood, 50%-70% of sickle cell patients have gallstones. Elective cholecystectomy is indicated for those who are symptomatic, but, because of operative mortality, there is disagreement concerning surgery for asymptomatic patients. The literature contains nine well-documented cases of acute hepatic failure related to sickle cell disease. The mechanism is unclear; however, as the necrosis is often not severe, a metabolic problem is suggested.
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PMID:Hepatobiliary system in sickle cell disease. 351 88

The Research Committee of the World Organization of Gastroenterology has gather information regarding the etiology of acute abdominal pain. Seven diseases cover 96% of the causes of this syndrome in many countries of the world, but some geographical variations have been observed. One example of these variations is amoebic liver abscess, present in 5 to 10% of Mexico City patients. Right upper quadrant pain is often present in amoebic liver abscess and acute cholecystitis. Thus, differential diagnosis of these two entities is difficult. Using discriminant analysis and "stepwise" procedures in 100 cases with cholecystitis and a similar number of patients with amoebic liver abscess, we found six variables (symptoms and signs with a significant chi square to distinguish between these two diseases. The symptoms and signs chosen were hepatomegaly, Murphy's sign, duration of pain greater than or equal to 48 hours, previous history of abdominal pain, dysentery, and facial pallor. These variables proved to be better than laboratory test results. With five of these variables it was possible to obtain an accuracy of 92%. Using six variables, if cases of tie (three variables present and three absent) were excluded, accuracy rose to 96%.
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PMID:Differential diagnosis between amoebic liver abscess and acute cholecystitis. 635 41