Definition

Hepatomegaly is swelling of the liver beyond its normal size.

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

See also: Splenomegaly

Figures

Alternative Names

Hepatosplenomegaly; Enlarged liver; Liver enlargement

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.

Common 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
• 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)
• Tumor metastases

Call your health care provider if

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

What to expect at your health care provider's office

The doctor 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 medications are you taking?
• 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

Bergasa MV. Approach to the patient with liver disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 149.

Pratt DS. Liver chemistry and function tests. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 73.

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