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

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

The liver is involved in many bodily functions and is affected by a variety of conditions, many of which result in hepatomegaly.

Causes of hepatomegaly may include:

• Alcohol use
• Congestive heart failure
• Glycogen storage disease
• Hemolytic-uremic syndrome (HUS)
• Hepatitis A
• Hepatitis B
• Hepatocellular carcinoma
• Hereditary fructose intolerance
• Infectious mononucleosis
• Leukemia
• Neuroblastoma
• 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)
• Tumor metastases

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

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 any fever?
• What medications are you taking?
• How much alcohol do you drink?

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

• Abdominal x-ray
• Ultrasound of the liver (must 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
• Other tests for suspected causes

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.