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Hepatomegaly

Hepatosplenomegaly; Enlarged liver; Liver enlargement

 

Hepatomegaly is swelling of the liver beyond its normal size.

If both the liver and spleen are enlarged, it is called hepatosplenomegaly.

Considerations

 

The lower edge of the liver normally comes just to the lower edge of the ribs on the right side. The edge of the liver is normally thin and firm. It cannot be felt with the fingertips below the edge of the ribs, except when you take a deep breath. It may be enlarged if a health care provider can feel it in this area.

 

Causes

 

The liver is involved in many of the body's functions. It is affected by many conditions that can cause hepatomegaly, including:

  • Alcohol use
  • Cancer metastases (spread of cancer to the liver)
  • Congestive heart failure
  • Glycogen storage disease
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatocellular carcinoma
  • Hereditary fructose intolerance
  • Infectious mononucleosis
  • Leukemia
  • Niemann-Pick disease
  • Primary biliary cirrhosis
  • Reye syndrome
  • Sarcoidosis
  • Sclerosing cholangitis
  • Steatosis (fat in the liver from metabolic problems such as diabetes, obesity, and high triglycerides, also called nonalcoholic steatohepatitis, or NASH)

 

When to Contact a Medical Professional

 

This condition is most often discovered by a health care provider. You may not be aware of the liver or spleen swelling.

 

What to Expect at Your Office Visit

 

The provider will examine you and ask questions such as:

  • Did you notice a fullness or lump in the abdomen?
  • What other symptoms do you have?
  • Is there any abdominal pain?
  • Is there any yellowing of the skin (jaundice)?
  • Is there any vomiting?
  • Is there any unusual-colored or pale-colored stools?
  • Have you had a fever?
  • What medicines are you taking including over-the-counter and herbal medicines?
  • How much alcohol do you drink?

Tests to determine the cause of hepatomegaly vary, depending on the suspected cause, but may include:

  • Abdominal x-ray
  • Abdominal ultrasound (may be done to confirm the condition if the doctor thinks your liver feels enlarged during a physical exam)
  • CT scan of the abdomen
  • Liver function tests, including blood clotting tests
  • MRI scan of the abdomen

 

 

References

Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 146.

 
  • Liver fattening, CT scan

    Liver fattening, CT scan - illustration

    A CT scan of the upper abdomen showing a fatty liver (steatosis of the liver). Note the liver enlargement and dark color compared with the spleen (gray body in lower right).

    Liver fattening, CT scan

    illustration

  • Liver with disproportional fattening, CT scan

    Liver with disproportional fattening, CT scan - illustration

    A CT scan of the upper abdomen showing disproportional steatosis (fattening) of the liver.

    Liver with disproportional fattening, CT scan

    illustration

  • Hepatomegaly

    Hepatomegaly - illustration

    Hepatomegaly is enlargement of the liver beyond its normal size. Certain conditions such as infection, parasites, tumors, anemias, toxic states, storage diseases, heart failure, congenital heart disease, and metabolic disturbances may all cause an enlarged liver.

    Hepatomegaly

    illustration

    • Liver fattening, CT scan

      Liver fattening, CT scan - illustration

      A CT scan of the upper abdomen showing a fatty liver (steatosis of the liver). Note the liver enlargement and dark color compared with the spleen (gray body in lower right).

      Liver fattening, CT scan

      illustration

    • Liver with disproportional fattening, CT scan

      Liver with disproportional fattening, CT scan - illustration

      A CT scan of the upper abdomen showing disproportional steatosis (fattening) of the liver.

      Liver with disproportional fattening, CT scan

      illustration

    • Hepatomegaly

      Hepatomegaly - illustration

      Hepatomegaly is enlargement of the liver beyond its normal size. Certain conditions such as infection, parasites, tumors, anemias, toxic states, storage diseases, heart failure, congenital heart disease, and metabolic disturbances may all cause an enlarged liver.

      Hepatomegaly

      illustration


     

    Review Date: 4/20/2015

    Reviewed By: Subodh K. Lal, MD, Gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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