Clinical Features of Hepatomegaly

1. Clinical Features of Hepatomegaly Schistosomiasis • Hepatomegaly is due to granuomatous lesion that causes a pre-sinusoidal block of blood flow. This leads to portal hypertension that eventually may complicate to esophageal varices • There is a RUQ “dragging” pain that may move to the LUQ as splenomegaly progresses. • History reveals exposure to fresh or salt water that developed a pruritic rash. It is associated with fever, lethargy, myalgia, dyspepsia and flatulence. Viral Hepatitis • Diffuse hepatomegaly is due to the inflammation of the liver brought about by the hepatitis virus induced liver damage • Patient present with history of prodromal symptoms like anorexia, nausea, vomiting, fatigue and myalgia. The RUQ pain and enlargement is associated with dark urine, acholic stools, jaundice and weight loss.

2. Clinical Features of Hepatomegaly Malaria • Diffuse hepatomegaly is due to the presence of sporozoites that form hypnozoites in infected hepatocytes. (in P. vivax and P. ovale) • History reveals recent travel of the patient in an endemic area. There’s also an associated cough, fatigue, malaise, paroxysm of fever, shaking chills, and sweats (every 48 or 72 h, depending on species) Miliary TB • Diffuse hepatomegaly occurs as a result of the hematogenous seeding of the TB bacilli after the primary infection. Once the bacteria reach the left side of the heart and enter the systemic circulation, the result may be to seed organs such as the liver and spleen. The disseminated nodules consisting of central caseating necrosis and peripheral epithelioid and fibrous tissue at lead to inflammatory responses in the liver • This is accompanied by  low grade fever, cough, and enlarged lymph nodes, and splenomegaly