Hepatomegally

Normal liver span: women 6-10cm man 8-12cm.

Describtion:

there is a mass on the RIGHT UPPER Quadrant:

- shape, size, edge, surface, consistency

- tender, pursatile, move up and down with respiration.

- ausculatation: bruit

eg: there is a mass on right upper quadrant which move with inspiration.

It is has irregular shape, smooth surface, well define age and firm consistency, liver span is 15 cm.

Cant get above it but can get below it.

it tender on palpation, non pursatile, dull on purcusssion and no bruit. 

so my differential diagnosis will be acute hepatitis, acute biliary obstruction, acute cholangitis and acute congestion of liver secondary to cardiac failure.

we should also consider other c auses of hepatomegally: (DIA MIC)

• Drug/toxic: alcohol
• Infection: hepatitis, abcess (amebic, pyogenic),thypoid
• Autoimmune : lupus hepatitis.
• metabolic: Wilson's disease
• Infiltative: benign (fatty liver), malignancy (lymp/myeloproliferative), hepatoma, metastasis.
• Congestion: Congestive heart failure

Tender liver:

• acute hepatitis
• acute cholangitis
• liver abcess
• acute bilirary obstruction
• acute congestion of liver due to congestive heart failure

Irregular and firm liver

• hepatoma, cirrosis, metastases and cystic liver.