Alternate Names: Hepatosplenomegaly; Enlarged liver; Liver enlargement

Considerations: The lower edge of the liver normally comes just to the lower edge of the ribs (costal margin) on the right side. In its normal state the edge of the liver is thin and firm, and it cannot be palpated (felt with the finger tips) below the edge of the costal margin. If the liver becomes enlarged enough that it can be palpated below the costal margin, the patient is said to have hepatomegaly.

The liver is involved in a multitude of bodily functions and is affected by a variety of conditions, many of which result in hepatomegaly. General classes of causes include infection (viral and bacterial), parasites, malignancy (tumors), anemias, toxic states, storage diseases, heart failure, congenital heart disease, and metabolic disturbances.

Common Causes:

• alcoholism
• hepatitis A
• hepatitis B
• congestive heart failure
• leukemia
• neuroblastoma
• Reye’s syndrome
• hepatocellular carcinoma
• Niemann-Pick disease
• Hereditary fructose intolerance
• glycogen storage disease
• tumor metastases
• primary biliary cirrhosis
• sarcoidosis
• sclerosing cholangitis
• hemolytic-uremic syndrome (HUS)

Home Care: Contact your health care provider.

Call If: (This finding is usually discovered by the health care provider, and the affected individual may or may not have been aware of its presence.)

What To Expect: The medical history will be obtained. This finding is usually discovered by the health care provider during a physical examination.

Medical history questions documenting hepatomegaly in detail include:

• time pattern
  • When did you notice a lump in the abdomen?
• quality
  • How much is the liver enlarged?
• other
  • What other symptoms are also present?
  • Is there any abdominal pain?
  • Is there any jaundice?
  • Is there any vomiting?
  • Is there any unusual-colored or pale-colored stools?

• abdominal film
• CT scan of the abdomen
• liver function tests, including blood clotting profiles
• other tests for suspected causes