Enlarged liver
Hepatosplenomegaly; Enlarged liver; Liver enlargementEnlarged 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.
Spleen
Splenomegaly is a larger-than-normal spleen. The spleen is an organ in the upper left part of the belly.
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. Its function is affected by many conditions that can cause hepatomegaly, including:
- Alcohol use (especially alcohol abuse)
- Cancer metastases (spread of cancer to the liver)
Metastases
Liver metastases refer to cancer that has spread to the liver from somewhere else in the body. Liver metastases are not the same as cancer that start...
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Congestive heart failure
Congestive heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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Hepatitis A
Hepatitis A
Hepatitis A is inflammation (irritation and swelling) of the liver from the hepatitis A virus.
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Hepatitis B
Hepatitis B
Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...
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Hepatitis C
Hepatitis C
Hepatitis C is a viral disease that leads to swelling (inflammation) of the liver. Other types of viral hepatitis include:Hepatitis AHepatitis BHepat...
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Hepatocellular carcinoma
Hepatocellular carcinoma
Hepatocellular carcinoma is cancer that starts in the liver.
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- Infectious mononucleosis
- Leukemia
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Niemann-Pick disease
Niemann-Pick disease
Niemann-Pick disease (NPD) is a group of diseases passed down through families (inherited) in which fatty substances called lipids collect in the cel...
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Primary biliary cholangitis
Primary biliary cholangitis
The bile ducts are tubes that move bile from the liver to the small intestine. Bile is a substance that helps with digestion. All of the bile ducts...
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Reye syndrome
Reye syndrome
Reye syndrome is characterized by sudden (acute) brain damage and liver function problems. This condition does not have a known cause. This syndrome...
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Sarcoidosis
Sarcoidosis
Sarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and/or other tissues.
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Sclerosing cholangitis
Sclerosing cholangitis
Sclerosing cholangitis refers to swelling (inflammation), scarring, and destruction of the bile ducts inside and outside of the liver.
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- 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 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?
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
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- Is there any vomiting?
- Is there any unusual-colored or pale-colored stools?
Pale-colored stools
Stools that are pale, clay, or putty-colored may be due to problems in the biliary system. The biliary system is the drainage system of the gallblad...
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- 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
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Abdominal ultrasound (may be done to confirm the condition if the provider thinks your liver feels enlarged during a physical exam)
Abdominal ultrasound
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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CT scan of the abdomen
CT scan of the abdomen
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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Liver function tests, including blood clotting tests
Liver function tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...
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MRI scan of the abdomen
MRI scan of the abdomen
An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...
References
Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 137.
Plevris J, Parks R. The gastrointestinal system. In: Dover AR, Innes JA , Fairhurst K, eds. Macleod's Clinical Examination. 15th ed. Philadelphia, PA: Elsevier; 2024:chap 6.
Squires JE, Balistreri WF. Manifestations of liver disease. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 382.
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Fatty liver - 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).
Fatty liver - CT scan
illustration
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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
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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
-
Fatty liver - 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).
Fatty liver - CT scan
illustration
-
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 - 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: 5/2/2023
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.