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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fascioliasis is becoming more frequently discovered among citizens of Alexandria. The main presenting clinical manifestations including hepatic pain, colics, fever, anorexia, discomfort with meals and hepatomegaly. We select here 4 cases with unusual presentation from patient's record of the last year: one case developed liver abscess due to F. hepatica infection. Two cases were encountered during cholecystectomy in patients suffering from cholecystitis with cholelithiasis; in one of them the gall bladder had ruptured and the patient developed an abscess in the liver related to the gall bladder bed. In both cases F. hepatica worms were found in the bile duct. The fourth case presented with acalcular cholecystitis with empyema of the gall bladder.
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PMID:Uncommon complications of human fascioliasis in Alexandria. 276 74

An attempt was made to assess discomfort in rats with hepatomegaly induced by feeding a high cholesterol, high cholate diet. After 8 weeks, the rats displayed a more than two-fold increase in liver weight when compared with controls fed a commercial diet. In a small open field test, behaviour of rats with hepatomegaly was similar to the controls. Of 9 parameters scored per rat, only the response to pressure on the right hypochondrium (tension of overlying muscles) scored higher than in control animals. There was considerable between-assessor variation in the assignment of scores. It is suggested, tentatively, that hepatomegaly in rats caused by cholesterol plus cholate feeding, may not cause extreme discomfort. Upon 'blind' palpation of control and test rats, an average of 60% of the rats with hepatomegaly were classified correctly.
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PMID:Assessment of discomfort in rats with hepatomegaly. 323 Aug 67

Giant hepatic cavernous hemangiomas are clinically distinct from smaller asymptomatic ones and may be confused with primary or metastatic malignancy. Hemangiomas exceeding 8 cm in diameter (mean, 13.7 cm) were studied in eight women 28-71 years old, six of whom presented with right upper quadrant discomfort and/or hepatomegaly. On unenhanced CT, seven of the masses were less dense than surrounding normal liver and one was slightly more dense than adjacent fatty liver. All masses contained additional stellate or cleftlike low-density zones, and two contained calcification. After bolus IV contrast administration, all exhibited early peripheral enhancement and partial centripetal isodense fill-in. None became completely isodense on delayed scans. Familiarity with these CT characteristics and a high index of suspicion should facilitate correct diagnosis and avert needle biopsy.
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PMID:CT of giant cavernous hemangioma. 349 95

Gaucher's disease involves the liver, the spleen, and the bone. Liver-spleen and bone scintigraphy were used during an 8-yr period to evaluate changes caused by this disease. Patients were investigated with a liver-spleen scan for abdominal pain, mechanical discomfort, enlarged liver or spleen on physical examination, abdominal mass, abnormal liver function tests, and symptoms of hypersplenism. Fourteen liver-spleen scans were performed in nine patients. Liver scintigraphy showed various degrees of enlargement and inhomogeneous uptake. In two patients focal defects were detected. In one, focal defects were due to liver involvement with Gaucher's disease, but in the other they were caused by metastatic pancreatic carcinoma. The study was also useful in detecting splenic infarction and in following enlargement of the spleen after partial splenectomy. The main indication for bone scintigraphy in six patients was bone pain. This was found to be caused by either aseptic necrosis of the head of the femur, bone infarction, pathological fractures, or osteomyelitis. Loosening after total hip replacement was ruled out in three patients and missed in one patient. Scintigraphy appears to be a simple, sensitive test for evaluation of the liver, spleen, and bony skeleton in patients with symptomatic Gaucher's disease.
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PMID:Scintigraphic findings in Gaucher's disease. 376 Sep 80

Disseminated histoplasmosis was diagnosed by a computed tomographic (CT) directed needle biopsy of an adrenal mass. A 53-year-old man presented with a nonproductive cough, bilateral flank discomfort, and constitutional symptoms. Physical exam revealed mild hepatomegaly and tenderness. Chest radiograph revealed two destructive bone lesions. An abdominal CT scan demonstrated bilateral adrenal masses. Needle biopsy of the left adrenal mass revealed histoplasmosis. A rib resection or exploratory laparotomy was avoided. He has been completely free of evidence of disease for 6 months following completion of antibiotic therapy.
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PMID:Disseminated histoplasmosis diagnosed by computed tomography directed needle biopsy of an adrenal mass. 399 31

Hepatocellular carcinoma (HCC) occurs more frequently in subsaharan Africa and the Orient than in other geographical regions, but remains an uncommon tumour of childhood. We review six children with HCC (mean age 13 years) treated by the paediatric oncology unit at Tygerberg Hospital in Cape Town over an 8-year period (1983 - 1990). Patients presented with epigastric and right upper quadrant discomfort and hepatomegaly. The hepatitis B serum antigen (HbsAg) was positive in three patients; serum alpha-fetoprotein (AFP) levels were markedly elevated in three (range 100 - 453,000 microg/l). Age and sex did not differ significantly and all patients initially had irresectable advanced-stage tumours. Morphologically, three were highly malignant adult-type pleomorphic HCCs, two were differentiated tumours, and one a fibrolamellar subtype. The mean 2-year survival was 33% and the 5-year survival 16.6%. The biological behaviour and response to treatment of the tumours varied. Whereas three patients had a poor response to therapy, two with poorly-differentiated tumours, negative HbsAg, and normal serum AFP levels responded to doxorubicin/cisplatinum chemotherapy. This facilitated radical surgical excision. One patient of this group has survived for more than 75 months following surgical resection and remains well. HCC remains an uncommon tumour of childhood with a high mortality. Aggressive chemotherapeutic regimes in combination with surgical resection may lead to improved survival in some cases. Prevention of hepatitis B remains a priority.
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PMID:Hepatocellular carcinoma in children. 909 43

We report the case of a middle-aged woman presenting epigastric discomfort, hepatomegaly, biochemical signs of cholestasis, bone marrow plasmocytosis and Bence Jones proteinuria. Percutaneous liver biopsy disclosed kappa light chain deposition disease of the liver and fine needle aspiration of abdominal fat showed amyloid substance. Renal blood chemistries and urinalysis were repeatedly normal. To our knowledge, this is the first reported case of kappa light chain deposition disease of the liver and concomitant amyloidosis without renal involvement as the first manifestation of plasma cell dyscrasia. This condition should be considered in the differential diagnosis of intrahepatic cholestatic liver disease.
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PMID:Kappa light chain deposition disease of the liver. 961 91

Myelofibrosis with myeloid metaplasia (MMM) is a collective term that describes the related disorders AMM, PPMM, and PTMM. The chronic myeloid disorders include chronic myeloid leukemia, polycythemia vera, essential thrombocythemia, and agnogenic myeloid metaplasia (myelofibrosis). These disorders display varying propensities for pathologic enlargement of the spleen which can lead to mechanical discomfort, hypercatabolic symptoms, anemia, thrombocytopenia, and portal hypertension. Splenectomy has been found to be of little benefit in the early stages of chronic myeloid leukemia. Similarly, the benefit of splenectomy in advanced cases is limited to symptomatic palliation and treatment of delayed engraftment after allogeneic bone marrow transplantation. Although polycythemia vera and essential thrombocythemia are also characterized by splenomegaly, splenectomy is not considered a therapeutic option in the absence of transformation of the disease into myelofibrosis with myeloid metaplasia. Splenectomy has been studied most in myelofibrosis with myeloid metaplasia. Although there is no clear survival advantage to splenectomy in this disorder, the surgical procedure can result in substantial palliation of mechanical discomfort, hypercatabolic symptoms, portal hypertension, and anemia. However, the procedure is associated with an approximately 9% mortality rate, and the postsplenectomy occurrence of extreme thrombocytosis, hepatomegaly, and leukemic transformation is of major concern.
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PMID:Splenectomy in chronic myeloid leukemia and myelofibrosis with myeloid metaplasia. 1098 48

In a prospective, randomized, double-blind therapeutic trial, 191 patients with non-alcoholic steatohepatitis were treated for 8 weeks daily b.i.d. orally either with betaine glucuronate combined with diethanolamine glucuronate and nicotinamide ascorbate (Ietepar) (96 patients) or with undistinguishable placebo capsules (95 patients). The verum treatment effectively reduced by 25% hepatic steatosis (p < 0.01) and by 6% hepatomegaly (p < 0.05), while placebo did not significantly reduce the disorders. Verum was also more effective than placebo on discomfort in abdominal upper right quadrant. The global efficacy of treatment was rated by the doctor "very good" or "good" in 48% of verum treated patients and only in 17% after placcbo (P of difference = 9 x 10(-6)). 52% of patients self-rated efficacy as "very good" or "good" after verum and only 34% after placebo (P of difference = 0.017). The verum treatment provoked a significant reduction of the increased liver transaminases (ALT, AST and gamma-GT) while placebo was ineffective. Adverse events were recorded in 10% of verum-treated patients and in 7% under placebo (no significant difference). In both groups the adverse events were mild and transient, did not require treatment discontinuation and were undistinguishable from common symptoms of liver disorders. In conclusion, the 8-week treatment with betaine glucuronate combined with diethanolamine glucuronate and nicotinamide ascorbate was found effective in non-alcoholic steatohepatitis, a disorder for which the hitherto pharmacological interventions were poorly and inconsistently effective.
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PMID:Efficacy and safety of oral betaine glucuronate in non-alcoholic steatohepatitis. A double-blind, randomized, parallel-group, placebo-controlled prospective clinical study. 1099 56

Hereditary fructose intolerance (HFI) is an autosomal recessive disease caused by catalytic deficiency of aldolase B (fructose-1, 6-bisphosphate aldolase). Herein we report on a case of hereditary fructose intolerance with initial presentation of episodic unconsciousness, seizure, hypoglycemia, hepatomegaly, and abnormal liver function since the patient was 11 months old. She was diagnosed as Reye's-like syndrome according to a liver biopsy done at 20 months of age. As she grew up, cold sweating, abdominal pain or gastrointestinal discomfort shortly after the intake of fruits was noted and she developed an aversion to fruits, vegetables and sweet-tasting foods. At 9 years of age, a fructose tolerance test signified a positive result that induced hypoglycemia, transient hypophosphatemia, hyperuricaemia, elevation of serum magnesium, and accumulation of lactic acid. Appropriate dietary management and precautions were recommended. The patient has been symptom-free and exhibited normal growth and development when followed up to 12 years of age.
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PMID:Hereditary fructose intolerance presenting as Reye's-like syndrome: report of one case. 1102 Oct 9


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