It is essential to estimate the liver size in the diagnosis of liver disease. Many approaches have beenattempted in the evaluation of liver size such as measurement of length, area and volume. Among these, area andvolume measurements are accurate but complicated. So various linear measurements including Pfahler's method havebeen commonly used. But to our knowledge, there was no report about linear diameter of liver in Korean adualts. Asingeneral, larger patients are likely to have larger liver than smaller ones, it seems to be more ideal toevaluate the liver size using relative ratio rather than absolute linear diameters. The main objectives of ourinvestigation were to determine the various diameters of normal and enlarged liver and the criteria ofhepatomegaly in Korean adults using absolute and relative ments. Our cases consisted of 95 clinically normalsubjects and 51 patients suffering from liver disease and diagnosed to have hepatomegaly on abdominal palpationand simple abdomen in the Dept. of Radiology, St, Mary Hospital during the period of 6 months since Jan. 1981. Wemeasured the liver size using 3 linear diameters. And as the reference measurement, the distance from the rightmargin of the liver to the left margin of spleen was also measured. We called this “abdominal transversediameter”(ATD). The results were as follows; 1. The diameters of liver were 13.4±1.6cm, 18.4±2.4cm, 19.2±2.6cmin normal group and 18.8±3.1cm, 23.5±3.0cm, 24.2±3.2cm in hepatomegaly group using midline verticaldiameter(MIVD), maximum vertical diameter (MAVD) and diagonal diameter(DD), respectively. The difference betweentwo groups were statistically very significant in every method(p<0.01). 2. The 99% tolerance limits of liverdiameters were 13.0-13.8cm, 17.8-19.0cm, 18.5-19.9cm in normal and DD, respectively. The midpoints between theupper limit of normal group and the lower limit spectively. These points are warranted to suggest criterias ofhepatomegaly. 3. There were statistical significant difference in the ratio of each diameter to ATD between normaland hepatomegaly group (p<0.01). We called this“hepato-abdominal ratio”. The “hepato-abdominal in hepatomegalygroup using MIVD, MAVD and DD, respectively. 4. The 99% tolerance limits of “hepato-abdominal ratio” were0.43-0.45, 0.59-0.63, 0.62-0.64 in normal group and 0.60-0.62, 0.75-0.77, 0.77-0.79 in hepatomegaly group usingMAVD, MAVD and DD, respectively. The midpoints between the upper limit of normal group and the lower limit ofhepatomegaly group were 0.52, 0.69, 0.70 using MIVD, MAVD and DD, respectively. These points are alsowarranted tosuggest criterias of hepatomegaly.
Abdomen ; Adult ; Diagnosis ; Hepatomegaly ; Humans ; Liver Diseases ; Liver ; Methods ; Spleen

We have experienced a case of hepatoblastoma in 22 months old male infant who presented with abdominal distention and hepatomegaly. Diagnosis was confirmed by X-ray of abdomen, liver scan and histological findings. A brief review of literature was also presented.
Abdomen ; Diagnosis ; Hepatoblastoma* ; Hepatomegaly ; Humans ; Infant ; Liver ; Male

Systemic amyloidosis results from the deposition of insoluble, fibrous amyloid proteins. It occurs mainly in the extracellular spaces of multiple organs and tissues including the kidney, heart, and liver. Although amyloid deposition in the liver is common in patients with systemic amyloidosis, clinically apparent liver disease is relatively rare. Indeed, most patients with systemic amyloidosis manifest only minimal to moderate hepatomegaly and trivial abnormalities in liver function tests. Recently, we experienced two cases of patients who presented with abnormalities in liver function tests and hepatomegaly as manifestations of systemic amyloidosis. We report these cases with a review of the relevant literatures.
Adult ; Amyloidosis/complications/*pathology ; Female ; Hepatomegaly/complications/*diagnosis/pathology ; Humans ; *Liver Function Tests ; Male ; Middle Aged

The authors describe three cases of hepatocellular carcinoma presenting with the initial manifestation of an intracranial lesion without primary hepatic symptoms and signs. The only clue of hepatic dysfuntion was mild elevation of the SGOT, SGPT, AIK-Pase and hepatomegaly. The diagnosis could not be made until operation. All three cases of hepatoma had metastasis to cranium. The literauture of hepatoma with cranial metastasis is reviewed.
Alanine Transaminase ; Aspartate Aminotransferases ; Carcinoma, Hepatocellular* ; Diagnosis ; Hepatomegaly ; Neoplasm Metastasis* ; Skull

The authors describe three cases of hepatocellular carcinoma presenting with the initial manifestation of an intracranial lesion without primary hepatic symptoms and signs. The only clue of hepatic dysfuntion was mild elevation of the SGOT, SGPT, AIK-Pase and hepatomegaly. The diagnosis could not be made until operation. All three cases of hepatoma had metastasis to cranium. The literauture of hepatoma with cranial metastasis is reviewed.
Alanine Transaminase ; Aspartate Aminotransferases ; Carcinoma, Hepatocellular* ; Diagnosis ; Hepatomegaly ; Neoplasm Metastasis* ; Skull

In 1953, Lichtenstein suggested to use “Histiocytosis X” as an unifying diagnostic term to represent Eosinophilic granuloma, Hand-Schiiller-Christian disease, and Letterer-Siwe disease. The author experienced a case of Hand-Schuller-Christian disease in six year old girl. She has been treated under the diagnosis of Calves disease. But later, it was confirmed as Hand-Schiiller-Christian disease by clinically and pathologically, involving multiple region of entire skeletal system, but sparing the musculocutaneous and nervous system. Clinically, anemia, malaise, high fever and hepatomegaly were present. Co60 isotope irradiation combined with antibiotics was done for 87 days twice weekly in a dose of 50 R at a time. At the time of discharge clinical symptoms were subsided. In X-Ray check, one year after treatment, bony defects were consolidated with new bone and the result was successful.
Anemia ; Anti-Bacterial Agents ; Diagnosis ; Eosinophilic Granuloma ; Female ; Fever ; Hepatomegaly ; Histiocytosis, Langerhans-Cell ; Humans ; Nervous System

A boy aged 11 years was admitted due to intermittent weakness and difficulty in walking for 6 years, and hepatomegaly, glycopenia and unconsciousness for 4 years. The laboratory examinations showed severe metabolic acidosis, hypoglycemia, and abnormal liver function. CT scan showed marked liver enlargement with fat density shadow. The boy was given fluid infusion, correction of acidosis, intravenous injection of glucose, L-carnitine, compound vitamin B, and coenzyme Q10, but he was in a persistent coma and it was difficult to correct refractory metabolic acidosis and hypoglycemia. The boy died. Blood and urinary organic acid screening and gene detection confirmed that the boy had late-onset glutaric aciduria type II (GAIIc) caused by electron-transferring-flavoprotein dehydrogenase (ETFDH) gene defect. GAIIc is an inherited metabolic disease with a low incidence, resulting in a high misdiagnosis rate. GAIIc should be considered for children with recurrent weakness or reduced activity endurance, hypoglycemia, and marked liver enlargement with abnormal liver function. Urinary organic acid analysis and blood tandem mass spectrometry can help with the early diagnosis of GAIIc, and ETFDH gene analysis helps to make a confirmed diagnosis.
Child ; Hepatomegaly ; etiology ; Humans ; Hypoglycemia ; etiology ; Male ; Multiple Acyl Coenzyme A Dehydrogenase Deficiency ; diagnosis ; Muscle Weakness ; etiology

Langerhans cell sarcoma (LCS) is a neoplastic proliferation of Langerhans cells with malignant cytological features and multi-organ involvement that typically has a poor prognosis. We experienced 2 cases of LCS in children less than 2 years of age and report them based primarily on CT and MR findings. Both children had findings of hepatosplenomegaly with low-attenuation nodular lesions, had multiple lymphadenopathy, and had shown recurrent lesions invading the skull during follow-up after chemotherapy.
Female ; Hepatomegaly/diagnosis ; Humans ; Infant ; Langerhans Cell Sarcoma/*diagnosis ; Magnetic Resonance Imaging ; Mediastinal Neoplasms/*diagnosis ; Neoplasm Recurrence, Local ; Skull Neoplasms/*diagnosis ; Splenomegaly/diagnosis ; Tomography, X-Ray Computed

Infantile hemangioendothelioma (IHE) is a benign tumor of the liver composed of anastomosing vascular channels lined by plump endothelial cells. The major clinical findings of IHE are abdominal mass, hepatomegaly, cutaneous hemangioma, congestive heart failure, anemia and disseminated intravascular coagulopathy. Precise diagnosis of IHE is crucial because medical therapies using steroid and/or interferon can be tried unless there are grave compressive symptoms. Along with CT scan and MRI studies, scintigraphic evaluation with 99mTc-RBC offers an accurate method of identification of these lesions, and allows differentiation from other common primary or secondary hepatic masses. We report two cases of giant IHE of the liver those were diagnosed with 99mTc- RBC scan and confirmed with pathologic evaluation after surgical removal.
Anemia ; Diagnosis ; Endothelial Cells ; Heart Failure ; Hemangioendothelioma* ; Hemangioma ; Hepatomegaly ; Interferons ; Liver* ; Magnetic Resonance Imaging ; Radionuclide Imaging* ; Tomography, X-Ray Computed

Visceral larva migrans is a syndrome presented chronic peripheral eosinophilia, hepatomegaly with eosinophilic granuloma. Originally it results from migration of second stage larva of Toxocara species, animal ascarides, but there are many other causative parasites. It's difficult to detect causative parasite, although immunohistochemical methods like ELISA or Ouchterlony method have been introduced. If the larva were dectected, it's not easy to discriminate causative one from others because of similarities of morphology. Most cases have self-limited course. Only in severe infection, antiparasitic treatment, augmented by corticosteroid when allergic symptopms are also present, is required. Clinical presentations have varieties of spectrum, hepatomegaly with eosinophilic granuloma is most common. Some cases of pulmonary, ocular and CNS symptoms were reported. We now report a case of visceral larva migrans, presented submucosal tumor or diverticulitis in the ascending colon and went through laparoscopic right hemicolectomy. The diagnosis was made with microscopic examination of operation tissue.
Animals ; Colon, Ascending* ; Diagnosis ; Diverticulitis ; Enzyme-Linked Immunosorbent Assay ; Eosinophilia ; Eosinophilic Granuloma ; Hepatomegaly ; Larva ; Larva Migrans, Visceral* ; Parasites ; Toxocara ; Toxocariasis