The liver is an important human organ. It performs a number of significant functions - it removes toxins, synthesizes hormones, cholesterol, some enzymes and participates in the metabolism. Malfunctions in the work of an organ affect the functioning of the whole organism as a whole. One of the common pathologies of the liver is hepatomegaly. In a child, this condition can be considered normal until a certain age, but there are situations where medical attention may be required. In this article, we consider the causes of pathology in children and possible treatment.
Definition
Hepatomegaly is a condition characterized by an enlarged liver due to a disease. But in children under 5, and sometimes even 7 years old, such a symptom can be considered an age-related feature that needs to be kept under medical supervision. In this case, the body extends beyond the ribs by 2 centimeters. In cases where there is a significant increase in the liver or pain is added to the pathology, nausea, as well as symptoms of other diseases, it is necessary to consult a doctor as soon as possible.
Causes of pathology
The causes of hepatomegaly in children are quite numerous, since the liver responds to any, even the most minor changes in the body. The main factors in the development of pathology include:
- Inflammatory processes. This is the most common cause in children. This includes rubella, viral diseases, hepatitis, intoxication, the presence of parasites in the organ.
- Metabolic disorders due to hereditary diseases or malnutrition.
- Violations of the outflow of bile and blood, which lead to blockage of the ducts of the gallbladder , vein thrombosis, heart failure.
- Damage to liver tissue. For example, with cysts or fibrosis.
- Malignant formations.
- Living in areas with poor ecology.
- Improper nutrition, which is dominated by fatty foods.
Pathology classification
- Reactive hepatomegaly in a child that has arisen under the influence of the development of pathological processes. As a rule, after eliminating the root cause, the size of the organ is restored to normal.
- Minor hepatomegaly in a child. The liver increases by 1–2 centimeters. In this case, the symptomatic picture is not observed. Diagnosed by ultrasound.
- In some situations, a moderate hepatomegaly of the liver is diagnosed in the child. It arises in connection with the response of the body to some infectious diseases. This condition does not pose a health threat if the root cause is eliminated. Symptoms are poorly expressed, mainly signs of pathology are manifested with a prolonged course of the underlying disease, in which organ dysfunctions occur. Diagnosed using instrumental methods.
- Severe liver hepatomegaly in a child. In this case, the organ may protrude beyond the ribs to a distance of 10 centimeters. A thorough diagnosis is required to identify the root cause and timely treatment. In most cases, this form develops during the oncological process.
- Diffuse. The liver exceeds the norm by more than 10 centimeters. Changes can be observed in any part of the body. In most cases, this condition occurs when exposed to staphylococcus and streptococcus. It is characterized by aching pain in the liver. If the cause of the pathological condition was a toxic lesion of the body, an additional symptom will be an enlarged spleen. This condition is life-threatening and requires immediate treatment, which is performed surgically. As an adjunct treatment, a special diet with the exception of fatty foods is recommended.
- Partial hepatomegaly in a child. An uneven organ enlargement is diagnosed. This happens if there is a tumor or cyst. Sometimes this condition is diagnosed by palpation, in which the tuberous surface of the enlarged liver is palpated.
- Hepatomegaly as hepatosis. There are situations in which the development of a pathological condition occurs due to the use of a large amount of fatty foods and when using certain categories of drugs. Due to the intake of excessive amounts of fats, they can accumulate in the liver cells, which causes hepatomegaly. This condition develops very slowly, but in the absence of therapy can provoke fibrosis and cirrhosis.
- False hepatomegaly. It is observed with emphysema, in which there is a "push" of the liver. This disease is well diagnosed using radiography.
Symptomatology
Manifestations of pathology directly depend on the cause that caused it. Most often, the following signs of moderate hepatomegaly in a child are observed:
- General malaise.
- Weakness.
- Apathy.
- Distraction.
- Decreased appetite.
- Yellowness of the skin.
- Intestinal disorders.
- Pain in the upper and right abdomen.
- Blood clotting disorder.
- Capillary stars appear on the baby’s stomach.
- Nausea or vomiting.
- The appearance of a bitter aftertaste in the mouth.
- Swelling of the abdomen.
- Heartburn.
It is worth noting that with a moderate type of pathology, the symptoms can be somewhat blurred, while with a diffuse type of disease, the symptoms are pronounced.
If any of the above symptoms appear, consult a specialist as soon as possible.
Diagnostic measures
If a child is suspected of developing a disease, the doctor will conduct a visual examination on which the liver area is palpated and will pay attention to examining the skin. After this, the necessary diagnostic measures are prescribed that will help to identify the provoking disease. Diagnostics includes a set of laboratory and instrumental examinations, which include:
- General analysis of urine and blood.
- Blood chemistry.
- Coagulogram.
- Hepatic tests.
- The immunogram.
- Examination of feces and blood for the presence of helminths.
- Ultrasound examination of the liver. When detecting hepatomegaly in a child, echoes of an increase in organ size are fundamental in identifying pathology.
- Magnetic resonance imaging or computed tomography.
- Roentgenography.
- In some cases, a biopsy is needed, which is usually performed under general anesthesia through laparoscopy. It is an informative diagnostic method, especially for tumor processes and fatty degeneration.
- Oncomarkers.
Possible treatment
The decision on how to treat hepatomegaly in a child is made by the attending physician based on the results of all tests taken. Self-medication can lead to irreparable consequences. With this pathology, an integrated approach is used, including conservative therapy, diet therapy and traditional medicine, which are used under the supervision of a doctor.
Drug therapy includes:
- Drugs that help fight the underlying provocative disease. These include anti-inflammatory, analgesic drugs, antibiotics, and antiviral drugs. Anthelmintic drugs may be prescribed.
- Hepatoprotectors prescribed to maintain the liver. These include drugs such as Essential, Heptral.
- Enzyme-containing preparations - "Creon", "Mezim".
- Antispasmodics. For example, No-shpa.
- Vitamin complexes containing vitamin C.
- Sorbents to combat intoxication.
- In case of liver failure, diuretic therapy is used, which includes taking Furasemide or, if indicated, Laparocentesis.
Diet therapy
In the treatment of hepatomegaly in children, adherence to a certain diet is an important step in which the load on the liver is reduced. Plant foods should predominate in the child’s diet, and the consumption of fatty, smoked foods and those that contain a large amount of simple carbohydrates should be reduced. Approved products include:
- Vegetables.
- Fruits.
- Low-fat meat and fish.
- Soups on vegetable broth.
- Dairy products with a low fat content.
- Jelly.
- Squirrels of eggs.
The use of the following product categories is prohibited:
- Spicy.
- Greasy.
- Smoked.
- Salty.
- Mushrooms.
- Chocolate.
- Carbonated drinks.
- Alcohol.
- Spice.
- Ice cream.
- Strong tea and coffee.
It is recommended to eat fractionally and in small portions.
Surgical treatment
In some cases, conservative therapy is not effective. In this case, the doctor decides on the use of a surgical method of treatment. This occurs in the following cases:
- With the development of purulent processes in the liver. For this, abscesses of the organ are opened and drained.
- In oncological processes to remove the tumor.
- For ligation of blood vessels in case of organ tissue damage.
Folk remedies
The use of traditional medicine is an auxiliary method of treatment, which should begin only after consulting with your doctor and excluding the likelihood of allergic reactions. It is worth noting that not all medicinal herbs can be used from an early age.
The following folk recipes are recommended:
- Honey mixed with a little lemon juice and water.
- Pumpkin, which is allowed to use in any form.
- Beet. You can either use it in boiled form, or squeeze juice out of it.
- A decoction of wild rose, motherwort, peppermint, St. John's wort.
- Cranberry juice.
Features of the course of the disease in newborns
A slight increase in the liver in newborns is a normal option and does not require treatment. It is quite simple to control this condition. But with a progressive enlargement of the organ, the cause should be identified as soon as possible and the necessary therapy should be started. The most common causes of hepatomegaly in newborns are:
- Congenital TORCH infections.
- Inflammatory diseases.
- Metabolic disorders.
- Pathology of the development of the liver.
- Tumor processes.
- Diseases of the cardiovascular system.
- Excess vitamin A levels in the body.
- Congenital liver fibrosis.
- Impaired lipid metabolism.
- Toxic liver damage due to drug treatment.
In this case, the following symptoms may be observed:
- Lack of appetite.
- Tearfulness of the child.
- Vomiting
- Blood coagulation disorders.
- Yellowing of the skin and mucous membranes.
Do not self-medicate, as you can harm the baby. First of all, it is necessary to identify the disease provoking an increase in the liver and direct all measures to its treatment. Medicines are also prescribed to restore liver cells. If the baby is breast-fed, it is recommended that mom change her diet, excluding foods prohibited during hepatomegaly. These include fatty, spicy, smoked, salty dishes.
Preventative measures
In order to prevent the development of hepatomegaly, it is necessary to adhere to a number of preventive measures, which include:
- Compliance with a healthy lifestyle.
- Proper nutrition.
- Compliance with the drinking regime.
- Strengthening immunity.
- Classes of moderate physical activity.
- Timely treatment of diseases and preventing their transition to the chronic stage.
- Compliance with personal hygiene.
- Prevention of infectious diseases.
- Also, adherence to mental health is of great importance for the prevention of moderate hepatomegaly in a child. Stress can lead to metabolic disorders and loss of appetite, which, in turn, affects the deficiency of trace elements and vitamins.
- Avoid overeating.
- More walk in the fresh air.
Forecast
The prognosis for this condition directly depends on the provoking disease and the severity of its course. With timely diagnosis and timely treatment started, the chances of a complete cure of the liver are very high, especially due to inflammatory processes of an infectious nature. In diseases that provoked intoxication, forecasts for a full recovery are slightly lower. The prognosis in this case will depend on the degree of damage to the body. More dangerous consequences are hepatomegaly caused by the development of tumors. At the same time, early diagnosis of the disease and timely treatment are of great importance.
Conclusion
Hepatomegaly in a child can be a sign of quite dangerous diseases that, without proper treatment, lead to serious complications. If this condition is not physiological in nature, if any symptoms appear, you need to contact a therapist or gastroenterologist who will prescribe diagnostic measures and, based on the results of the results, the most effective treatment for each particular case.