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Enlarged liver

Hepatosplenomegaly; Enlarged liver; Liver enlargement

Enlarged liver refers to swelling of the liver beyond its normal size. Hepatomegaly is another word to describe this problem.

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:

When to Contact a Medical Professional

This condition is most often detected by a 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 fullness or a 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?
  • Has your urine appeared to be darker than usual (brownish)?
  • 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:

References

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

Plevris J, Parks R. The gastrointestinal system. In: Innes JA, Dover AR, Fairhurst K, eds. Macleod's Clinical Examination. 14th ed. Philadelphia, PA: Elsevier; 2018:chap 6.

Pomeranz AJ, Sabnis S, Busey SL, Kliegman RM. Hepatomegaly. In: Pomeranz AJ, Sabnis S, Busey SL, Kliegman RM, eds. Pediatric Decision-Making Strategies. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27.

Review Date: 3/26/2019

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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