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Jaundice is not a disease, but rather a sign that can occur in many different diseases. Jaundice is the yellowish staining of the skin and sclerae (the whites of the eyes) that is caused by high levels in blood of a chemical bilirubin. The color of the skin and the whites of the eyes vary depending on the level of bilirubin. When the bilirubin level is mildly elevated, they are yellowish. When the bilirubin level is high, they tend to be brown.
If the jaundice is caused by blockage of the bile ducts, no bile enters the intestine. Bile is necessary for digesting fat in the intestine and releasing vitamins from within it so that the vitamins can be absorbed into the body. Therefore, blockage of the flow of bile can lead to deficiencies of certain vitamins. For example, there may be a deficiency of vitamin K that prevents proteins that are needed for normal clotting of blood to be made by the liver, and, as a result, uncontrolled bleeding may occur.
Diseases causing inflammation of the bile ducts, for example, primary biliary cirrhosis or sclerosing cholangitis, and some drugs, can reduce the flow of bile and elimination of bilirubin leading to jaundice. Blockage of the bile ducts The most common causes of blockage of the bile ducts are gallstones andpancreatic cancer. Less common causes include cancers of the liver and bile ducts. Drugs Many drugs can cause jaundice and/or cholestasis. Some drugs can cause liver inflammation (hepatitis) similar to viral hepatitis. Other drugs can cause inflammation of the bile ducts, resulting in cholestasis and/or jaundice. Drugs also may interfere directly with the chemical processes within the cells of the liver and bile ducts that are responsible for the formation and secretion of bile into the bile ducts or the intestine. As a result, the constituents of bile, including bilirubin, are retained in the body. The best example of a drug that causes this latter type of cholestasis and jaundice isestrogen. The primary treatment for jaundice caused by drugs is discontinuation of the drug. Almost always the bilirubin levels return to normal within a few weeks, though in a few cases it may take several months. Genetic disorders There are several rare genetic disorders present from birth that give rise to jaundice. Crigler-Najjar syndrome is caused by a defect in the conjugation of bilirubin in the liver due to a reduction or absence of an enzyme responsible for conjugating the glucuronic acid to bilirubin. Dubin-Johnson and Rotor's syndromes are caused by abnormal secretion of bilirubin into bile. The only common genetic disorder that may cause jaundice is Gilbert's syndrome which affects approximately 7% of the population. Gilbert's syndrome is caused by a mild reduction in the activity of the enzyme responsible for conjugating glucuronic acid with bilirubin. The increase in bilirubin in the blood usually is mild and infrequently reaches levels that cause jaundice. Gilbert's syndrome is a benign condition that does not cause health problems, although patients with Gilbert's syndrome may develop gallstones more frequently. Developmental abnormalities of bile ducts There are rare instances in which the bile ducts do not develop normally and the flow of bile is interrupted. Jaundice frequently occurs. These diseases usually are present from birth though some of them may first be recognized in childhood or even adulthood. Cysts of the bile duct (choledochal cysts) are an example of such a developmental abnormality. Another example is Caroli's disease.
ESPAOL
Hepatomegaly
Email this page to a friendShare on facebookShare on twitterBookmark & SharePrinter-friendly version Hepatomegaly is swelling of the liver beyond its normal size. If both the liver and spleen are enlarged, it is called hepatosplenomegaly. See also: Splenomegaly Considerations The lower edge of the liver normally comes just to the lower edge of the ribs on the right side. The edge of the liver is normally thin and firm. It cannot be felt with the fingertips below the edge of the ribs, except when you take a deep breath. It may be enlarged if a health care provider can feel it in this area. Causes The liver is involved in many of the body's functions. It is affected by many conditions that can cause hepatomegaly, including: Alcohol use Congestive heart failure Glycogen storage disease Hepatitis A Hepatitis B Hepatitis C Hepatocellular carcinoma Hereditary fructose intolerance Infectious mononucleosis Leukemia Niemann-Pick disease Primary biliary cirrhosis Reye syndrome Sarcoidosis Sclerosing cholangitis Steatosis (fat in the liver from metabolic problems such as diabetes, obesity, and high triglycerides, also called nonalcoholic steatohepatitis, or NASH) Tumor metastases
When to Contact a Medical Professional This condition is usually discovered by a health care provider. You may not be aware of the liver or spleen swelling.
What to Expect at Your Office Visit The doctor will examine you and ask questions such as: Did you notice a fullness or lump in the abdomen? What other symptoms do you have? Is there any abdominal pain? Is there any yellowing of the skin (jaundice)? Is there any vomiting? Is there any unusual-colored or pale-colored stools? Have you had a fever? What medications are you taking? How much alcohol do you drink?
Tests to determine the cause of hepatomegaly vary, depending on the suspected cause, but may include: Abdominal x-ray Abdominal ultrasound (may be done to confirm the condition if the doctor thinks your liver feels enlarged during a physical exam) CT scan of the abdomen Liver function tests, including blood clotting tests MRI scan of the abdomen
Hepatomegaly is the condition of having an enlarged liver. It is a nonspecific medical sign having many causes, which can broadly be broken down into infection, direct toxicity, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.
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2.1 Infective 2.2 Neoplastic 2.3 Cirrhotic 2.4 Metabolic 2.5 Drugs and toxins 2.6 Congenital 2.7 Others