The liver is an important human organ. It performs a number of significant functions - removes toxins, synthesizes hormones, cholesterol, some enzymes and participates in metabolism. Malfunctions in the work of the body 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 up to a certain age may be considered normal, but there are situations when medical attention may be required. In this article, we will consider the causes of pathology in children and possible treatment.
Definition
Hepatomegaly is a condition characterized by enlargement of the liver due to a disease. But in children under 5, and sometimes 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 protrudes beyond the ribs by 2 centimeters. In those caseswhen there is a significant increase in the liver or pain, nausea, and symptoms of other diseases are added to the pathology, you should see a doctor as soon as possible.
Causes of pathology
The causes of hepatomegaly in children are quite numerous, as the liver reacts 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. These include rubella, viral diseases, hepatitis, intoxication, the presence of parasites in the body.
- Metabolic disorders due to hereditary diseases or malnutrition.
- Disturbances in the outflow of bile and blood, resulting in blockage of the gallbladder ducts, vein thrombosis, heart failure.
- Damage to liver tissue. For example, with cysts or fibrosis.
- Malignant tumors.
- Living in areas with bad ecology.
- Unhe althy diet, which is dominated by fatty foods.
Classification of pathology
- Reactive hepatomegaly in a child, which arose under the influence of the development of pathological processes. As a rule, after the root cause is eliminated, 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 situationsDiagnose moderate hepatomegaly of the liver in a child. It occurs in connection with the body's response to certain infectious diseases. This condition does not pose a threat to he alth if the underlying cause is eliminated. Symptoms are poorly expressed, mainly the signs of pathology are manifested during the long course of the underlying disease, in which there are violations of the function of the organ. Diagnosed using instrumental methods.
- Severe hepatomegaly of the liver in a child. In this case, the organ can protrude beyond the ribs at a distance of up to 10 centimeters. Careful diagnosis is needed to identify the underlying 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 would 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 no fatty foods is recommended.
- Partial hepatomegaly in a child. An uneven increase in the organ is diagnosed. This happens when there is a tumor or cyst. Sometimes this condition is diagnosed by palpation, in whichthe bumpy surface of the enlarged liver is palpable.
- Hepatomegaly by the type of hepatosis. There are situations in which the development of a pathological condition occurs due to the consumption of a large amount of fatty foods and the use of certain categories of drugs. Due to the intake of an excessive amount of fats, their accumulation in the liver cells can occur, which causes hepatomegaly. This condition develops very slowly, but if left untreated, it can provoke fibrosis and cirrhosis.
- False hepatomegaly. It is observed in emphysema, in which the liver is "pushed out". This disease is well diagnosed by radiography.
Symptomatics
The manifestations of pathology directly depend on the cause that caused it. The most common signs of mild hepatomegaly in a child are:
- General malaise.
- Weakness.
- Apathy.
- Distraction.
- Decreased appetite.
- Yellowness of the skin.
- Intestinal disorders.
- Pain in the upper and right side of the abdomen.
- A bleeding disorder.
- Capillary stars appear on the baby's stomach.
- Nausea or vomiting.
- Appearance of a bitter taste in the mouth.
- Swelling of the abdomen.
- Heartburn.
It is worth noting that with a moderate type of pathology, the signs may be somewhat blurred, while with a diffuse type of disease, the symptoms are pronounced.
WhenIf you experience any of the above symptoms, you should see 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 he will palpate the liver area and pay attention to the examination of the skin. After that, the necessary diagnostic measures are prescribed to help identify the provoking disease. Diagnosis includes a set of laboratory and instrumental examinations, which include:
- General analysis of urine and blood.
- Biochemical blood test.
- Coagulogram.
- Liver tests.
- Immunogram.
- Examination of feces and blood for the presence of helminths.
- Ultrasound examination of the liver. When detecting hepatomegaly in a child, echo signs of an increase in the size of the organ are the main ones in detecting pathology.
- Magnetic resonance or computed tomography.
- X-ray.
- In some cases, a biopsy is necessary, which is usually performed under anesthesia through laparoscopy. It is an informative diagnostic method, especially in case of tumor processes and fatty degeneration.
- Tumor markers.
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. For this pathology,an integrated approach that includes conservative therapy, diet therapy and traditional medicine, which are used under the supervision of a physician.
Medication includes:
- Drugs that help fight the underlying provocative disease. These include anti-inflammatory drugs, pain relievers, antibiotics, and antiviral drugs. Antihelminthic drugs may be prescribed.
- Hepatoprotectors prescribed to support the liver. These include drugs such as Essentiale, Heptral.
- Enzymatic preparations - Creon, Mezim.
- Anspasmodics. For example, "No-shpa".
- Vitamin complexes containing vitamin C.
- Sorbents to combat intoxication.
- In liver failure, diuretic therapy is used, including taking "Furasemide" or, if indicated, "Laparocentesis".
Diet therapy
In the treatment of hepatomegaly in children, adherence to a specific diet is an important step in which the load on the liver is reduced. The diet of the child should be dominated by plant foods, and the consumption of fatty, smoked foods and those that contain a large amount of simple carbohydrates should be reduced. Allowed products include:
- Vegetables.
- Fruits.
- Lean meat and fish.
- Soups with vegetable broth.
- Low fat dairy products.
- Jelly.
- Egg whites.
The following food categories are prohibited:
- Spicy.
- Bold.
- Smoked.
- S alty.
- Mushrooms.
- Chocolate.
- Soda drinks.
- Alcoholic drinks.
- Spices.
- Ice cream.
- Strong tea and coffee.
It is recommended to eat fractionally and in small portions.
Surgical treatment method
In some cases, conservative therapy is ineffective. In this case, the doctor decides on the use of a surgical method of treatment. This happens in the following cases:
- With the development of purulent processes in the liver. To do this, open and drain the abscesses of the organ.
- In oncological processes to remove the tumor.
- For ligation of vessels in case of damage to organ tissues.
Folk remedies
The use of traditional medicine is an auxiliary method of treatment, which should only be started after consulting with your doctor and eliminating the possibility of allergic reactions. It is worth noting that not all medicinal herbs can be used from an early age.
It is recommended to use the following folk recipes:
- Honey mixed with a little lemon juice and water.
- Pumpkin, which is allowed to be consumed in any form.
- Beets. You can either use it boiled or squeeze juice out of it.
- Decoction of wild rose, motherwort, mint, St. John's wort.
- Cranberry juice.
Features of the course of the disease in newborns
Slight enlargement of the liver in newborns is normal and does not require treatment. It can be enough just to keep this condition under control. But with a progressive increase in 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.
- Pathologies of liver development.
- Tumor processes.
- Diseases of the cardiovascular system.
- Exceeding the level of vitamin A in the body.
- Congenital liver fibrosis.
- Disturbance of lipid metabolism.
- Toxic liver damage due to drug treatment.
The following symptoms may be observed:
- Lack of appetite.
- Crying baby.
- Vomiting.
- Blood clotting disorders.
- Yellowing of the skin and mucous membranes.
You can not self-medicate, as you can harm the baby. First of all, it is necessary to identify the disease that provokes an increase in the liver and direct all measures to its treatment. Medicines are also prescribed to restore liver cells. If the child is breastfed, the mother is advised to change her diet by excluding foods prohibited in hepatomegaly. These include fatty, spicy, smoked,s alty dishes.
Preventive measures
In order to prevent the development of hepatomegaly, it is necessary to adhere to a number of preventive measures, which include:
- Keeping a he althy lifestyle.
- Proper nutrition.
- Compliance with the drinking regime.
- Strengthening immunity.
- Moderate exercise.
- Timely treatment of diseases and prevention of their transition to the chronic stage.
- Maintain personal hygiene.
- Prevention of infectious diseases.
- Also, for the prevention of moderate hepatomegaly in a child, mental he alth is of great importance. Stress can lead to metabolic disorders and loss of appetite, which, in turn, affects the deficiency of trace elements and vitamins.
- Don't overeat.
- More outdoor activities.
Forecast
The prognosis for this condition directly depends on the provoking disease and the severity of its course. With timely diagnosis and timely treatment, the chances of a complete cure for the liver are very high, especially due to inflammatory processes of an infectious nature. With diseases that provoked intoxication, the forecasts for a complete recovery are somewhat lower. The prognosis in this case will depend on the degree of damage to the body. Hepatomegaly caused by the development of tumors has more dangerous consequences. At the same time, early diagnosis of the disease and timely treatment started 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 should contact a therapist or gastroenterologist who will prescribe diagnostic measures and, based on the results obtained, the most effective treatment for each specific case.
