Suffering From Sensitive Stomach. Diagnosed Hepatosplenomegaly. Cause? Complications?

Posted on Mon, 10 Jun 2013

Question: My Child is 8 years old. He has a sensetive stomache and easy to voimt just like his mother since he was an infant. Along the past 2 weeks, his stomache pain is revisiting daily.. We thought it to be nervous colon due to exams.. But when the doc suggested a sonar we found mild hepatosplinomegaly with 1 cm increase beyond normal size of liver and spline. He never got blood transfusion nor was subject to operations. What could be the reason nd complications?

Answered by Dr. Luchuo Engelbert Bain (3 hours later)

Hi and thanks for the query,
A proper clinical evaluation is actually important to ascertain the cause of this abdominal pain. A hepatosplenomegaly of 1cm, should not be a major call for concern, especially in a context like Egypt. Common parasitic infections like Malaria or other Mosquito transmitted infections could lead to slightly larger spleens in children in these areas.

Considering the fact that the child has been really unwell for two weeks, other causes of the raised or increased splenic/liver size must be considered. It is important to know if the child has developed jaundice lately, or has experienced any febrile illness lately. Diseases like viral hepatitis, septicemias or bacterial infections should be considered at this stage. Notion of diarrhea should be noted. A complete blood count to indicate the hemoglobin levels, number of white blood cells and platelets could be a good start in orienting an appropriate diagnosis. With the aid of markers of inflammation like Erythrocyte sedimentation rate and C reactive protein, common atypical conditions like retrohepatic appendicitis should be considered and excluded. Measurement of the liver enzyme levels (SGOT, SGPT) could be important to know if there is any problem with the liver. If raised, detailed exams in search of viral hepatitis could then be asked for. The abdominal ultrasound is an operator dependent exam. At times, it might be necessary to repeat and abdominal ultrasound to be sure, especially when the difference in parameters from the normal are not too pronounced.

I really suggest you revisit her pediatrician for a reevaluation and management.
Thanks and best regards. Do not hesitate asking further questions if need be.
Best regards,
Luchuo, MD.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Luchuo Engelbert Bain (41 hours later)

Thank you for your reply. In fact his doctor requested that we have some liver function analysis and Blood picture. The results are per the attached report. I know his readings fit in the normal range but had a comment from an unspecialized friend that his SGpt of 12 is too little for his age (8 years) whereby it should have read 21-23... Can you plz asses and advise on that and what it means?

Answered by Dr. Luchuo Engelbert Bain (57 minutes later)

Hi and thanks for the query,

There is a notion with respect to biological readings that needs to be understood. The ranges are usually based on averages, reason why it is presented in ranges.
Secondly, being below 21 is actually not something to worry about. It becomes serious and deserves checking when it is above the upper limit or boarder.
These values are however liable to fluctuations depending on stress and few physiologic changes.

I suggest you need not really be bothered with respect to the ranges.

Thanks and best regards,
Luchuo, MD.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Mohammed Kappan