HOME HELP CONTACT US SUBSCRIPTIONS CME ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 21 No. 9, September 2000 Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wolf, A. D. Articles by Lavine, J. E. Search for Related Content PubMed PubMed Citation Articles by Wolf, A. D. Articles by Lavine, J. E. Social Bookmarking                         What's this?

Hepatomegaly in Neonates and Children

Ann D. Wolf, MD^*
Joel E. Lavine, MD, PhD

^* Chief Resident.

Associate Professor of Pediatrics and Chief, Joint Program in Gastroenterology and Nutrition, Department of Pediatrics, UCSD School of Medicine, San Diego, CA.

	OBJECTIVES

 
After completing this article, readers should be able to:

1. Identify the possible causes of simultaneous hepatomegaly and splenomegaly.
   
2. List the important diagnostic considerations in patients who have hepatomegaly.
   
3. Delineate the most helpful initial radiographic test.
   
4. Describe what clinical findings occurring concomitantly in a patient who has hepatomegaly suggest metabolic or storage disease.
   
5. List the risk factors for infectious hepatitis.
   

	Introduction

 
Hepatomegaly can represent intrinsic liver disease or may be the presenting physical finding of a generalized disorder. Early diagnosis and treatment of children who have liver disease is important because specific treatments are available for some diseases that can prevent disease progression or hepatic failure.

The presence of a palpable liver does not always indicate hepatomegaly. Normal liver size is based on normative values of liver span by percussion, degree of extension below the right costal margin, or length of the vertical axis estimated from imaging techniques. In general, a liver edge greater than 3.5 cm in newborns and greater than 2 cm in children below the right costal margin suggests enlargement. Liver span is determined by measuring the distance between the upper edge, determined by percussion, and the lower edge, determined by palpation, in the midclavicular line. The lower border also may be determined by auscultation. With the stethoscope placed below the xiphoid, the examiner should gently scratch superiorly, starting in from the right lower quadrant, and listen for sound enhancement as the finger passes over the liver edge. Liver span increases linearly with body weight and age in both genders and correlates more with weight than with height. The normal range for liver span by percussion at 1 week of age is 4.5 to 5 cm. At 12 years, the normal value for boys is 7 to 8 cm and for girls is 6 to 6.5 cm.

The liver . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M. Fishbein, J. Mogren, C. Mogren, S. Cox, and R. Jennings Undetected Hepatomegaly in Obese Children by Primary Care Physicians: A Pitfall in the Diagnosis of Pediatric Nonalcoholic Fatty Liver Disease Clinical Pediatrics, March 1, 2005; 44(2): 135 - 141. [Abstract] [PDF]