Clinical and Radiological Evaluation of Normal Liver Sizes in Malnourished Children: Gazi-Pulsam Liver Scale

Background: Malnutrition is a serious childhood problem and has been shown to have negative effects on organ sizes in animal studies. Hence, specific size ranges must be determined for solid organs such as the liver in malnourished children. We observed that liver dimensions were interpreted within normal limits radiologically in malnourished children with hepatomegaly on physical examination. Thus, we aimed to show the possibility of differences in clinical and radiological interpretations in malnourished children and to establish the normal radiological dimensions of the liver according to the degree of malnutrition. Methods: Our study was conducted in patients aged 3 months to 3 years with malnutrition and imaging records between January 2008 and March 2020. Interpretations of physical examination results and radiological organ sizes were compared in malnourished children who had hepatomegaly on physical examination. Findings: We identified the inconsistency between the physical examination and radiological findings in detecting hepatomegaly in malnourished patients with hepatomegaly on physical examination. In our study, malnourished children with hepatomegaly but no liver-related diseases were examined, and new percentage values were determined for the radiological dimensions of the liver to be used in evaluating such children (The Gazi-PULSAM Liver Scale). Interpretation: No study has compared physical examination and imaging methods in malnourished children. The normal ranges of liver sizes were defined radiologically using the The Gazi-PULSAM Liver Scale for malnourished children. The Gazi-PULSAM Liver Scale has been shown to be more sensitive in terms of radiological evaluation of hepatomegaly in malnourished children with hepatomegaly on physical examination. Funding: None to declare. Declaration of Interest: The authors declare no conflict of interest. Ethical Approval: This study was approved by Gazi University Clinical Research Ethics Committee.