Enlarged liver or Hepatomegaly in children

The liver is an important organ located in the upper right quadrant of the abdomen. It is responsible for:

• Filtering the blood.
• Making bile, a substance that helps digest fat and excrete certain fatty substances
• Processing and hooking fats to carriers (including cholesterol), and storing sugars, helping the body transport and save energy.
• Making important proteins, such as most of those involved in blood clotting.
• Metabolizing many medications, such as barbiturates, sedatives, and amphetamines.
• Storing iron, copper, vitamins A and D, and several of the B vitamins.
• Making important proteins like albumin that regulate fluid transport in the blood and kidneys.
• Helping break down and recycle red blood cells.

Signs and symptoms of enlarged liver:

• Tenderness. If the liver enlarges quickly, it may be tender to the touch.
• Pain. A markedly enlarged liver may cause abdominal pain or fullness.
• Jaundice. If the cause of enlargement affects liver function, it may lead to yellowing of the skin (jaundice).

Common causes of liver enlargement in children are:

• Viral hepatitis like hepatitis A.
• Galactosemia, an inherited disease in which the body cannot tolerate certain sugars in milk. These sugars can build up, causing serious damage to the liver and other organs of the body.
• Alagille's syndrome, a condition in which the bile ducts narrow and deteriorate, especially during the first year of life
• Alpha 1- antitrypsin deficiency, a genetic liver disease in children that can lead to hepatitis and cirrhosis of the liver
• Neonatal hepatitis, which is hepatitis that occurs in a newborn during the first few months of life
• Tyrosinemia, a disorder that causes serious problems with liver metabolism
• hemorrhagic telangiectasia, a condition in which thin blood vessels allow frequent and easy bleeding of the skin and digestive tract
• Reye's syndrome, a condition that causes a buildup of fat in the liver. This condition has been linked in some cases to use of aspirin, especially in conjunction with chickenpox, influenza, or other illnesses with fever.
• Wilson's disease, an inherited condition that causes a buildup of the mineral copper in the liver
• Thalassemia, a group of hereditary anemia’s, or low red blood cell counts
• Biliary atresia, a condition in which the bile ducts extending from the liver to the intestine are too small in diameter or are missing
• Chronic active hepatitis, an inflammation of the liver that causes severe scarring and interference with liver function
• Cancer of the liver, which may result from cancer in other parts of the body that have spread to the liver.
• High doses of vitamins like A and D.
• Certain medications like prolonged use of acetaminophen, certain antibiotics, steroids can lead to enlargement of liver.

Diagnosis:

• X-ray examination.
• Ultrasound scan.
• CT scan of the abdomen.
• Liver function tests.
• Liver biopsy.

Treatment involves treating the cause for enlargement of liver.