Differential Diagnosis for Abnormal Liver on CT Scan in an 8-Year-Old Child
Single Most Likely Diagnosis
- Viral Hepatitis: This is a common cause of liver abnormalities in children, often presenting with elevated liver enzymes and potentially identifiable on CT scan through signs such as hepatomegaly or changes in liver texture.
Other Likely Diagnoses
- Fatty Liver Disease: Although more common in adults, fatty liver disease can occur in children, especially with increasing rates of obesity. It can cause liver enlargement and changes visible on a CT scan.
- Congenital Hepatic Cysts: These are benign anomalies that can be detected on imaging studies like CT scans. They are relatively common and can be present from birth.
- Liver Abscess: Although less common, a liver abscess can occur in children, often as a result of bacterial infection. It would appear as a localized collection of pus within the liver on a CT scan.
Do Not Miss Diagnoses
- Hepatoblastoma: This is the most common primary liver cancer in children. Early detection is crucial for treatment, making it a "do not miss" diagnosis despite its relative rarity.
- Wilson's Disease: An inherited disorder that leads to copper accumulation in the liver, potentially causing liver damage. It's essential to diagnose early to prevent long-term liver damage.
- Budd-Chiari Syndrome: A condition caused by obstruction of the hepatic veins, which can lead to liver enlargement, ascites, and potentially life-threatening complications if not recognized and treated promptly.
Rare Diagnoses
- Polycystic Liver Disease: A rare genetic disorder characterized by the growth of numerous cysts filled with fluid in the liver. It's more commonly diagnosed in adults but can be present in children.
- Glycogen Storage Diseases: A group of inherited disorders that result from defects in enzymes involved in glycogen synthesis or breakdown, leading to accumulation of abnormal amounts or types of glycogen in liver cells.
- Alagille Syndrome: A genetic disorder that affects the liver and other parts of the body, characterized by a reduction in the number of bile ducts within the liver, leading to bile build-up and liver damage.