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Hepatomegaly in Newborns

Aka: Hepatomegaly in Newborns, Splenomegaly in Newborns, Neonatal Hepatomegaly, Liver Mass in Infants, Congenital Liver Mass

Evaluation: Hepatomegaly with Direct Hyperbilirubinemia
1. Splenomegaly
  1. TORCH Virus Infection
  2. Bacterial Infection (e.g. Spirochetes) or Sepsis
  3. Disordered carbohydrate metabolism
    1. Galactosemia
    2. Hereditary Fructose Intolerance
2. No Splenomegaly
  1. Causes found on right upper quadrant Ultrasound
    1. Hepatoma or Hemangioma and other tumor
    2. Choledochal cyst
  2. Causes found on biliary scan
    1. Biliary atresia
  3. Causes found on liver biopsy
    1. Neonatal hepatitis
    2. Toxin exposure
    3. Parenteral nutrition
Evaluation: Hepatomegaly with Indirect Hyperbilirubinemia
1. Causes
  1. Congestive Heart Failure
  2. Toxin Exposure
  3. Hemolytic Anemia
    1. Hereditary spherocytosis
    2. Thalassemia
2. Studies
  1. Right Upper Quadrant Ultrasound
Evaluation: Hepatomegaly without Hyperbilirubinemia
1. Studies
  1. Abdominal Ultrasound
2. Causes with Splenomegaly
  1. Vascular obstruction
  2. Liver tumor (e.g. Hepatoblastoma)
  3. Metabolic disease
3. Causes without Splenomegaly
  1. Tumor
  2. Mother with Gestational Diabetes
  3. Malnutrition
References
1. Cloherty (1991) Neonatal Care, p. 449
2. Wolf (2000) Pediatr Rev 21(9):303-10

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 6/18/2013.

This is one of 5909 pages in the Family Practice Notebook