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)

A patient with liver abscess in association with regional enteritis is reported. Liver abscess should be suspected in patients with regional enteritis who present with fever, elevated serum alkaline phosphatase, liver tenderness, right upper quadrant pain or hepatomegaly.
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PMID:Liver abscess. A complication of regional enteritis. 50 33

Primary benign liver tumors are rare, however, the diagnosis should be considered in young women with right upper quadrant pain and an enlarged liver, expecially if they are taking oral contraceptives. These tumors are best resected promptly because of the frequency of spontaneous rupture. In the case reported, the patient was a 29-year-old housewife, gravida 1, para 1. Diarrhea of 8 years' duration was complained of. Anticholinergic sedatives and birth control pills were being used, and tetracycline, 250 mg daily, had been taken for acne for 5 years. A tender liver mass was palpable 3 cm below the ribs. Upper GI X-rays showed a mass displacing the small bowel. Liver scan showed an enlarged right lobe. At surgery a large encapsulated tumor of the right lobe of the liver was found. Subtotal hepatic lobectomy and cholecystectomy were done. The laboratory diagnosis was vascular liver tumor, type undetermined. Photographic reproductions illustrate histologic findings. Following surgery the diarrhea ceased and the patient has remained well. Hepatic angiography, although not done in this case, is considered to be a useful diagnostic method. Percutaneous liver biposy is contraindicated due to the vascular nature of these tumors.
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PMID:Hepatic adenoma and oral contraceptive therapy. 85 Oct 22

Adult polycystic liver disease is an entity that is striking for the presence of extraordinary hepatomegaly. Very rarely do patients under 40 years of age experience problems and only a minority of middle-aged patients manifest symptoms due to organ compression or biliary tree obstruction. The clinical course is usually benign, and no specific therapy is required. The onset of right upper quadrant pain, back pain, and shortness of breath prompted evaluation of a 32-year-old woman with progressive hepatomegaly. CT scan revealed a massive cyst-riddled liver with posterior displacement of the spleen, compression of the pancreas, and renal cysts. Prothrombin time, albumin, and liver enzyme values were normal except for a mildly elevated gamma-glutamyl transpeptidase.
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PMID:Symptomatic adult polycystic liver disease in a young woman. 175 23

Sonography and duplex Doppler frequently fail to identify a cause for right upper quadrant pain, liver dysfunction, or ascites. The aim of our study was to describe and analyze the pulsatile portal venous waveform in which minimum velocity dropped to or below zero on duplex Doppler sonography and to investigate its possible association with tricuspid regurgitation, one of the causes of liver dysfunction. We correlated the findings in 15 patients in whom this duplex Doppler waveform was seen with the findings on Doppler echocardiography (n = 14) or ultrafast CT (n = 1). All patients had biochemical liver abnormalities or sudden onset of ascites, rapid weight gain, increased abdominal girth, and hepatomegaly. They were referred for sonography to rule out liver metastases, biliary disease, portal vein thrombosis, or Budd-Chiari syndrome. All examinations were done with a 3-MHz phased-array sector transducer with duplex Doppler capability. Seventeen volunteers with no known liver or heart disease served as a control group. We correlated maximum and minimum flow velocities on the portal venous Doppler waveform with the portal vein diameters of the study and control groups. Thirteen patients were later proved to have tricuspid regurgitation, one patient had an aortic-right atrial fistula owing to rupture of an aneurysm of the sinus of Valsalva, and one patient was proved to be normal. In none of the 17 control subjects was this pulsatile portal venous waveform seen. Our study shows that detection of a pulsatile portal venous waveform on duplex Doppler sonography in patients with liver dysfunction should raise the possibility of tricuspid regurgitation.
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PMID:Pulsatile portal vein flow: a sign of tricuspid regurgitation on duplex Doppler sonography. 211 8

The medical records of 222 patients with liver abscess at Siriraj Hospital from 1978 to 1985 were analysed. Amoebic abscess was three times more prevalent than pyogenic abscess. In both groups middle aged males were affected more often than others. The main clinical manifestations were fever, right upper quadrant pain and hepatomegaly. History of colitis in the past, marked leukocytosis, elevation of alkaline phosphatase and a single abscess confined to the right lobe were suggestive of amoebic liver abscess. The presence of concurrent abdominal infection, marked anemia and jaundice were associated with pyogenic abscess. Patients with pyogenic abscess developed complications more often and the case fatality rate was greater than patients with amoebic abscess. Most of the patients were successfully treated with a combination of antimicrobials and drainage.
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PMID:Liver abscess: a clinical study of 222 patients. 221 15

29 patients with amebic liver abscess were evaluated in a study to examine clinical picture, laboratory data, epidemiology, radiologic methods, and therapy. Since the clinical picture was unspecific a considerable amount of misdiagnoses occurred, and often originated from pulmonary symptoms. To establish diagnosis one should rely on the triad with positive amebic serology, intrahepatic scanning defects, and clinical picture with fever, right upper quadrant pain, and hepatomegaly. Nearly all patients had an exposure history of travel or immigration from endemic areas in the tropics. Medical therapy with metronidazole alone is highly effective and leads to defervescence and clinical improvement usually within 3-5 days. Invasive procedures, such as needle aspiration or surgical drainage of the abscess are rarely needed; these invasive methods neither shorten the course of the disease nor improve prognosis.
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PMID:Clinical features and management of amebic liver abscess. Experience from 29 patients. 265 4

Although choledochal cyst is generally considered a disorder of childhood, in approximately 20% of patients a cyst is first recognized in adult life. We reviewed nine adults who underwent operation for choledochal cyst from 1974-1985 at Yale New Haven Hospital. Presenting symptoms included: crampy right upper quadrant pain, jaundice, pruritus, cholangitis, pancreatitis, hepatomegaly, and elevated liver function tests. Seven patients had undergone previous biliary surgery. The eight patients with type I cysts underwent complete excision of the cysts with Roux-Y choledochojejunostomy. One patient with a type IVa cyst underwent Roux-Y cystjejunostomy. All patients had complete resolution of biliary symptoms. There were no deaths, serious complications, or development of biliary malignancy in the 6 months to 13 years of follow-up. Optimum treatment of choledochal cyst is complete excision with reconstruction by Roux-Y choledochojejunostomy.
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PMID:Choledochal cysts in the adult. 298 Jul 68

Hepatic veno-occlusive disease is a nonthrombotic obliteration of small intrahepatic veins by loose connective tissue. The venous occlusion may be progressive and lead to massive hepatocellular necrosis. Although originally described as a result of intoxication with plant alkaloids, it is now seen as a complication of high-dose antineoplastic chemotherapy, especially in the setting of bone marrow transplantation. The incidence of hepatic veno-occlusive disease after bone marrow transplantation approaches 20 percent, with mortality ranging from 7 to 50 percent. The clinical diagnosis may be quite accurate (as confirmed by biopsy or autopsy) and is based on the triad of jaundice, hepatomegaly and/or right upper quadrant pain, and ascites or unexplained weight gain. The pathogenesis is obscure but most likely relates to drug-induced venous endothelial damage. At the present time, therapy for veno-occlusive disease of the liver remains supportive. As intensive chemotherapy regimens (with or without bone marrow support) become more widely applied, it is expected that this disease will be encountered more frequently.
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PMID:Hepatic veno-occlusive disease. 352 87

The possible association of hepatocellular carcinoma with oral contraceptive (OC) use is supported by the case of a 33-year old black female, gravida 5, para 4. She presented in April 1978 with right upper quadrant pain, nausea, vomiting, and fatty food intolerance. The case had been taking norethindrone, 1 mg with mestranol 0.05, for 2 years. There was no history of liver disease, alcohol abuse, or exposure to chemical toxins. The preoperative diagnosis was subacute cholecystitis; however, an unresectable primary liver tumor of both lobes was detected on surgery. OC use was discontinued, and the case refused chemotherapy. On December 1, 1978, she presented with a 9-week pregnancy which was aborted. Physical examination revealed an enlarged liver and mass in the upper right quadrant. The patient was readmitted December 11 with intractable pain and discharged. She died December 28, 1978. At autopsy the liver tumor appeared as a moderate to poorly differentiated hepatoma with irregular hyperchromatic nuclei. There was no evidence of coexistent benign lesions. The rapid progression of the disease following pregnancy suggests that hepatic growth was stimulated by the high estrogen levels of pregnancy. Earlier diagnosis and improved management are required in such cases. Ultrasonography can be used to confirm the presence of a mass, and liver scan or hepatic angiogram may be useful. Liver biopsy is required for definitive diagnosis. Treatment involves discontinuation of OC use and complete excision of the tumor where possible. If tumors have progressed beyond the stage of resectability, as in this case, the prognosis is poor.
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PMID:Hepatocellular carcinoma associated with oral contraceptive use and pregnancy. 629 72

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


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