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Hepatosplenomegaly (commonly abbreviated HSM) is the simultaneous enlargement of both the liver (hepatomegaly) and the spleen (splenomegaly).Hepatosplenomegaly can occur as the result of acute viral hepatitis, infectious mononucleosis, and histoplasmosis or it can be the sign of a serious and life-threatening lysosomal storage disease.
Aflatoxins were not found in liver samples of individuals with marasmus. [25] It has been known that the liver organ is the main target of aflatoxins and chronic toxicity can result in immunosuppressive and carcinogenic effects. [25] However, there is currently conflicting evidence to pinpoint a connection between kwashiorkor and aflatoxins.
Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line, with some standard measurements [2] Right lobe of the liver at the midclavicular line at ages 0 to 7 [16] Suspicion of hepatomegaly indicates a thorough medical history and physical examination, wherein the latter typically includes an increased liver span.
Doppler ultrasound of the liver is typically utilized to confirm or suggest the diagnosis. Common findings on liver doppler ultrasound include increased phasicity of portal veins with eventual development of portal flow reversal. The liver is usually enlarged but maintained normal echogenicity. A liver biopsy is required for a definitive diagnosis.
For liver fibrosis assessment, percutaneous liver biopsy, with or without image guidance, is contraindicated in uncooperative people. [70] Transjugular liver biopsy is indicated for any person with diffuse liver disease who needs a biopsy but has a contraindication to percutaneous biopsy or needs a hemodynamic evaluation for diagnostic purposes.
Chronic liver disease takes several years to develop and the condition may not be recognised unless there is clinical awareness of subtle signs and investigation of abnormal liver function tests. Testing for chronic liver disease involves blood tests, imaging including ultrasound, and a biopsy of the liver. The liver biopsy is a simple ...
The King's College criteria were described in a seminal publication in 1989 by J.G. O'Grady and colleagues from King's College School of Medicine. [2] 588 patients with acute liver failure who presented to King's College Hospital from 1973 to 1985 were assessed retrospectively to determine if there were particular clinical features or tests that correlated poorly with prognosis.
for liver transplantation in acute liver failure [25] Patients with paracetamol toxicity. pH < 7.3 or Prothrombin time > 100 seconds and serum creatinine level > 3.4 mg/dL (> 300 μmol/L) if in grade III or IV encephalopathy. Other patients. Prothrombin time > 100 seconds or Three of the following variables: Age < 10 yr or > 40 years; Cause ...