Hepatomegaly - Causes, Symptoms, Diagnosis, Prevention & Treatment

Hepatomegaly - Enlarged Liver Condition

Dr.Shamsudin  Mohamed Rela profile Authored by Dr.Shamsudin Mohamed Rela on 24 Jun 2014 - 10:18.

Hepatomegaly is the medical terminology used to denote enlargement of the liver ('hepato'- liver, 'megalo'- enlargement). It is not exactly a disease; rather it is a sign of a prevailing health issue or diseases. It occurs in various conditions and its presence warrants physician consultation

Hepatosplenomegaly is a condition where liver enlargement is associated with spleen enlargement. The liver is located in the upper right-hand portion of the abdominal cavity, beneath the diaphragm and on the top of right kidney, intestines and besides stomach. Its primary function is the production of bile, blood proteins, cholesterol and many others helping in the metabolism of nutrients, coagulation and immunity. In addition it helps in clearing the blood of ammonia, drugs and other harmful substances.

Diverse range of diseases and underlying conditions can be the reason of Hepatomegaly. Following are some commonly known diseases and conditions:

  • Fatty liver diseases

In India, fatty liver is one of the main causes of hepatomegaly mainly because of the sedentary life, improper food habits and the presence of obesity, diabetes and hypertension. If left untreated it will slowly damage the liver and can develop cancer.

  • Alcoholic liver disease.
  • Infections in the liver in the form of

o   Viral infections like Hepatitis A, B and C, cytomegalovirus, herpes etc

o   Bacterial infections like pyogenic abscess, salmonellosis (Bacterial dysentery)

o   Parasitic infections like amoebic liver abscess, hydatid disease, malaria.

  • Infections in the gall bladder.
  • Presence of liver cysts (pockets filled with the fluid).
  • Presence of hemangioma and adenoma (noncancerous tumors).
  • Cancer of the liver or any spread from other cancers.
  • Blood cancers like leukemia and lymphoma.
  • Obstruction of the veins that drain the liver.
  • Failure of the heart or heart attack.
  • Few pharmaceutical drugs.
  • Other rare genetic disorders like Glycogen storage disease, Amyloidosis, Wilson's disease, Hemachromatosis, Gaucher's disease.

Hepatomegaly may not cause any signs and symptoms unless it is accompanied by any other underlying liver disease. In that case, commonly seen symptoms are:

  • Pain in the abdomen – Right upper abdomen. Infective and inflammation etiologies develop painful hepatomegaly.
  • Fatigue
  • Vomiting
  • Nausea
  • Symptoms of jaundice like discoloration (yellowing) of the skin, dark yellow urination or yellowing of the eyes. It will be associated with itching in patients with bile duct or gallbladder problems.

The patient may have to undergo certain tests and examinations to confirm the diagnosis of the enlarged liver and to delineate its cause.

These tests and examinations include:

Physical examination: To determine the enlargement of the liver by external touch. Healthy liver is not felt in the abdomen (behind the rib cage) on examination. However it can be felt below the rib cage in hepatomegaly. It is often estimated based on the extension of the liver below the rib cage which indicates the enlarged liver. Abnormal liver may be spongy, firm or irregular, based on the underlying cause of the condition.

Once the enlarged liver is detected through physical examinations, the patient may have to undergo certain additional teststo detect the underlying cause. These tests may include:

  • Blood examinations – Complete blood count, Liver function test and coagulation to check for liver functioning status and to trace out the presence of any infection affecting the liver, like hepatitis.
  • Imaging tests – Ultrasonography is the basic screening test to find out the liver related problem and if warranted computerized tomography (CT) scan, magnetic resonance imaging (MRI) needs to be done to characterize any liver lesions.
  • Liver biopsy – This might be required in few situations to help in the diagnosis or starting treatment. The procedure includes inserting a needle to take out sample tissue from the damaged liver, which is then tested in the laboratory. 

Having any of the liver diseases like fatty liver, liver cancer, infection, gallbladder infection etc., increases the risk of developing Hepatomegaly. In addition, following are several factors that may increase the risk.

  • Excessive alcohol consumption.
  • Excessive use of medicines.
  • Taking extra vitamins and supplements (more than recommended).
  • Taking some herbal supplements including ma hunag, mistletoe and black cohosh.
  • Certain infections like malaria, hepatitis and Q fever.
  • Obesity and unhealthy diet.


Treatment measures for enlarged liver may include medications, surgery or radiotherapy depending on the underlying cause of the condition. Thus, the initial aim of the Hepatomegaly treatment is to trace out the exact cause of the disease and then approach with suitable management strategies.  

Prevention is always better than cure!

  • Eating healthy –  including fruits, vegetables and whole grains in your daily diet
  • Limiting the alcohol consumption or quitting
  • Physical exercise and maintaining a healthy weight
  • Avoiding excess and unnecessary use of medications.
  • Avoiding extra dose of vitamins and supplements
  • Protecting from the exposure of toxic chemicals, which may be harmful to the liver. These mainly include insecticides, aerosols and other toxic chemicals.
  • Limiting the smoking
  • Taking supplements only when recommended by the doctor. 
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.