The liver is responsible for the processes of digestion, the fight against microbes and the removal of toxic substances. It is the largest endocrine gland in the human body. In a child who has just been born, her weight is an eighteenth of the total body weight. Sometimes an enlarged liver in a newborn is an occasion for a complete medical examination.
Norm and pathology
Enlarged liver is a common occurrence in children's lives, doctors say. However, it should be remembered that in a he althy child under the age of 5, this organ should protrude a maximum of 2 cm from under the edge of the rib. And parents should not worry if the liver is slightly larger. A slight increase in this organ is typical for many children under 5 years of age and does not require special attention. The alarm should be raised when hepatomegaly occurs, which is accompanied by an increase in the diseased organ of the child by 1-5 cm.
In any case, pathological or normal changes in the liver are diagnosed innewborn doctor by palpation. If necessary, the child is referred for an additional ultrasound.
When examining a baby, it should be borne in mind that the liver of a newborn may have an elongated or flattened shape. Sometimes the phenomenon of "additional" tissues is observed in children. These are parenchymal neoplasms that surround the main organ.
Often the liver is enlarged in a newborn with jaundice. This is a physiological problem that arises due to the fact that the gland is not yet able to fully cope with its functions in comparison with intrauterine development. After two weeks, these symptoms disappear without a trace.
An enlarged liver in a newborn 2 months old and older can no longer be a sign of physiological jaundice. It is necessary to look for another cause of the disease.
Sometimes the main factor in the yellowness of the skin of a child can be excessively fatty mother's milk. The baby's body is unable to qualitatively process and assimilate it. In this case, stopping breastfeeding and switching to artificial nutrition is indicated.
Factors of pathologies in infants
If a newborn has an enlarged liver, the reasons should be sought in violations of the internal organs. Among the main factors that can cause pathological changes in the gland, the following can be distinguished:
- Primary defeat. It is provoked by the presence of a cyst, hemorrhagictelangiectasia or biliary cirrhosis.
- Inflammatory processes. In infants, they appear due to congenital infections (rubella, herpes, cytomegalovirus, hepatitis of all groups), blockage of the bile ducts, and similar disorders.
- Diabetic hepatosis.
- Hereditary pathology of metabolism. In a newborn, an enlarged liver and spleen may indicate amyloidosis, Gaucher disease, Neman-Pick.
- Difficulty in the outflow of blood and bile due to the pathology of the excretory tract, cirrhosis of the liver and other diseases.
- Cooper cell hyperplasia, which can be triggered by excessive amounts of vitamin A, sepsis, hepatitis.
It also happens that a baby is born with poor absorption of sugar. This results in an enlarged liver.
False and moderate hepatomegaly
How do doctors explain the term? Other ailments can also affect the change in the size of the liver in a newborn. It is not uncommon for doctors to diagnose the so-called false hepatomegaly. It occurs when the lungs in newborns greatly increase with the development of emphysema. This situation can be traced on x-ray images. The lungs seem to displace the liver from its place. At the same time, the organ itself is not damaged and no pathological changes occur in it.
Mild hepatomegaly occurs when the baby's body is fighting an infection. Such a struggle causes an enlarged liver in a newborn baby.due to excessive load on it during illness. This phenomenon does not apply to pathological conditions and does not require special treatment. However, it is worth keeping the situation under control.
How hepatomegaly manifests
This ailment is not considered a disease in the full sense of the word, but is only a manifestation of problems with the liver. To determine it, you should pay attention to a number of indicators:
- The baby's skin and mucous membranes acquire a characteristic yellowish tint.
- Becomes noticeably enlarged and bloated.
- There are problems with feeding the baby. The kid flatly refuses to eat, is naughty, becomes whiny.
- The chair turns white.
- Baby has bad breath.
- A network of vessels appears on the skin of a newborn.
- Pain occurs when pressing on the child's stomach.
- Nausea, vomiting noted.
- Frequent burping appears.
- Sleep disturbances occur, the baby often cries at night.
If a child has at least one of these symptoms, you should not hesitate to see a doctor for a minute.
Tests and examinations
To make a diagnosis, an examination by a pediatrician, internist, hematologist, gastroenterologist and infectious disease specialist will be required. In this case, the child is assigned a number of tests and examinations: blood monitoring to study the main biochemical parameters, radiography, electrocardiography and echocardiography.
Most completea picture for the diagnosis of liver disease can provide an ultrasound procedure. Thanks to it, it will be possible to determine the size and pathological changes that take place in the organ. In difficult cases, a biopsy may be used. If there are suspicions of hereditary diseases, an additional consultation with a geneticist is prescribed.
Ultrasound and CT examination
Ultrasound and CT will be the most effective for accurate diagnosis of liver diseases in newborns. However, when performing CT scans for infants, sedation is often used, and this is dangerous for the child's body, so ultrasound is most often the choice. During this examination, pathological changes in the liver are diagnosed according to the following indicators:
- Increased right or left lobe (or both).
- Protrusion of the organ by 0.4 cm or more from the edge of the rib.
- Smoothing the angle of the left lobe (he althy, it is somewhat pointed).
- Enlargement and inflammation of the hepatic lymph node.
Among additional indicators that may indicate specific diseases:
- Presence of a cyst or cystic formations. They may be congenital or indicate parasitic infestation.
- Deformation of the portal vein. Normally, in a small child, its diameter should not exceed 41 mm.
- Heterogeneity of organ tissues, increased echogenicity. May indicate intrauterine infection with infectious diseases and viruses.
- Development of neoplasms of round or irregular shape with peripheral blood flow.
OnBased on these and other examinations, treatment of the affected liver is prescribed. In this case, suitable drugs are used and special procedures are carried out.
Therapy depends directly on the causes of liver damage. If it was a virus, the baby is prescribed antiviral drugs, if the child has problems in the metabolic system from birth, then this is regulated by medication. An indication for surgery may be abnormal features of the structure of the bile ducts or heart defects.
When diagnosing hepatomegaly in a newborn, hepatoprotectors, antibiotics, antiviral drugs and enzymes are prescribed.
Mom's diet - he althy baby's liver
For effective treatment of liver diseases of a newborn, it is first of all necessary to accurately establish the cause of the disease. An important point is the observance of the diet by patients, doctors say. Since most newborns feed on mother's milk, the basic requirements for proper nutrition apply to a nursing woman. First of all, all fatty, spicy foods, smoked meats, alcohol, nuts, milk, coffee, tea, cocoa and chocolate should be excluded from the diet. Do not drink carbonated drinks during this period. The daily diet of a woman should consist of boiled meat, stewed fish, vegetables, fruits.
Any disease, including one that affects the liver, is subject to effective treatment when it is detected at the initial stages. That's whyparents should pay special attention to the child's malaise and seek medical help in a timely manner. It is necessary to conduct research and find out why the newborn has an enlarged liver. Self-medication in this case can lead to irreparable damage to he alth and loss of precious time.