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DD of Hepatomegaly
DD of Hepatomegaly
D of Hepatomegaly
Normal-12-15 cm
Determining the liver size is considered to be the
“simplest” and “cheapest” liver function test and,
”chronologically speaking, it is also the “first
The liver is enlarged
Size, edge, surface,
,consistency, tender
bruit or pulsatile
Massive Liver
HCC/Secondaries/myeloprolif
RVF
Alcoholic liver disease
Mild-moderate Liver
As above plus
Infection
Viruses – EBV, CMV, hepatitis A & B
Bacteria – Weil’s disease (leptospirosis), abscesses, TB,
brucellosis, syphilitic gumma
Protozoal – hydatid cysts, amoebic abscess
Malignancy – lymphoproliferative, myeloproliferative,
primary, secondary, adenoma from OCP
Infiltrative – sarcoid (erythema nodosum, lupus
pernio), amyloid, fatty liver
Endocrine – acromegaly, hyperthyroid
Collagen Vascular disease
Chronic hemolytic anaemia( AI, thalassemia, HS)
Reidel’s lobe
Possibility of minimal CLD signs with just hepatomegaly
Tender Liver
Liver abscess/infective (viral/bacterial/parasitic)
HCC/Secondaries
Right Heart Failure/Budd chiari
Pulsatile Liver
TR
HCC
AVM
Hard/Irregular Liver
Mitotic (primary/Secondary)
Macronodular cirrhosis (post hepatitis B/C, Wilson’s )
Amyloidosis/Hydatid cyst/granulomatous disease/gummatous disease/APCKD