Liver Enlargement In Children


Liver Enlargement In Children

    The enlargement of the liver is considered normal if it ranges between 4-5 cm in newborns, and between 6-8 cm in children aged approximately 12 years, and hepatomegaly can be defined as the descent of the edge of the liver to the bottom. The costal margin is about 3.5 cm in newborns, and about 2 cm in older children.

Causes of an Enlarged Liver in Children

    It can be said that hepatomegaly in children occurs as a result of five basic processes, the first of which is hepatitis and infection, for example, cases of exposure to bacterial, viral, parasitic, or fungal infections, as well as cases of inflammation resulting from infection with immune diseases. Autoimmune hepatitis, and then it is known as autoimmune hepatitis, and hepatitis may occur as a result of taking some types of medications. 

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    As for the second process that results in suffering from an enlarged liver, it is represented by the presence of problems in the liver’s ability to store the products of metabolic processes, such as glycogen, and excessive tyrosinemia, and Gaucher’s disease, as well as the presence of Disturbances in the storage of fats, iron, and copper. 

    As for the third cause, it is known as infiltration, which means filling the relevant space with cancer cells, for example what happens in cases of primary hepatic tumors and cases of cancer spread through blood or lymphocytes. As for the fourth cause, it is the accumulation of blood in the liver, as a result of suffering from congestive heart failure, some forms of pericarditis, and Budd chiary syndrome. 

    Finally, hepatomegaly can occur as a result of a blockage in the biliary system, as is the case when gallstones appear.

Symptoms Of An Enlarged Liver In Children

    In fact, children with enlarged liver often do not show any symptoms or signs in the early cases of the disease, but the liver continues to enlarge and increase in size, it may cause pressure in the area, and the patient begins to feel pain in the abdomen, and the severity of the abdominal pain depends on the extent of the liver enlargement, The greater the inflation, the greater the severity of the pain, and besides, the child shows symptoms of yellowing of the skin and whites of the eyes, and this is known as jaundice. Or lose weight, and he may feel pain when feeling the area where the liver is.


    In addition, there are some symptoms and signs that may appear in children with an enlarged liver, depending on the cause, which can be stated as follows:

  • fever.
  • Nausea and vomiting.
  • Failure to thrive.
  •  Decreased ability of the nervous system.
  •  Changes at the level of the skin, often represented by cutaneous hemangioma, the emergence of what is known scientifically as purpura, in addition to popular acrodermatitis.
  • Eye-level problems, usually with cataracts, Kayser-Fleischer rings, chorioretinitis, and posterior embryotoxic.
  • Changes at the level of the abdomen, such as an enlarged spleen (in English: Splenomegaly), the appearance of an abnormal sound when the stethoscope is placed on the patient’s liver, in addition to the possibility of feeling a cyst in the area.

Diagnosis of Hepatomegaly in Children

     In order for the patient to be diagnosed correctly, his condition must be properly evaluated by asking the child’s parents and relatives about the child’s age, health history and the conditions to which he was exposed, and a physical examination, in addition to the need to conduct some tests, and this can be summarized in the following :

  • History of the patient: The specialist doctor should know the patient’s health history, including jaundice, and whether he suffers from hepatitis, bile duct problems, gastrointestinal bleeding, or symptoms related to inflammation in the intestines. In addition to the need to know the family history of the individual in terms of liver diseases, metabolic problems, neurological disorders, and so on. The doctor should know whether the child has been exposed to certain types of medications, or has risk factors for any of the five types of viral hepatitis, and ask about its development, growth and capabilities, and finally, it is necessary to know whether the mother has been exposed during pregnancy to this newborn to any One of the types of infection.
  • Laboratory tests: such as urinalysis, complete blood count, electrolytes, blood sugar, protein, albumin, and liver enzymes.
  • Imaging: such as CT-scan, magnetic resonance imaging, and ultrasound.
  • Biopsy: a sample of liver tissue is taken.

Hepatomegaly in Children


    Since there are a number of factors and conditions that cause a child to suffer from an enlarged liver, then it can be said that the treatment of the cause entails the treatment of hepatomegaly, and it is worth noting that the specialist doctor sometimes, especially in simple cases of hepatomegaly, dispenses some anti-inflammatory Anti-inflammatory drugs) to control the disease, but in very severe and advanced cases, the option of liver transplantation can be resorted to.