Hepatomegaly

Hepatomegaly is the condition of having an enlarged liver. It is a non-specific medical sign having many causes, which can broadly be broken down into infection, direct toxicity, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdominal mass. Depending on the cause, it may sometimes present along with jaundice.

Diagnosis

A suspicion of hepatomegaly indicates a thorough medical history and physical examination, wherein the latter typically includes an increased liver span. Blood tests should be done, importantly liver-function series, which will give a good impression of the patient's broad metabolic picture.

An ultrasound of the liver can reliably detect a dilated biliary-duct system, which helps distinguish parenchymal liver disease from extrahepatic bile-duct obstruction. Ultrasound can also detect the characteristic texture of a cirrhotic liver, and can guide fine-needle aspiration of cysts, abscesses and tumours.

Computed tomography or (computerized tomography) (CT) can help to obtain more accurate anatomical information, and is unaffected by obesity or the presence of bowel gases.

Common causes

Infective

• Glandular fever (Infectious mononucleosis) This is caused by the Epstein-Barr virus (EBV). A similar condition (pseudoglandular fever) may be caused by the Cytomegalo virus (CMV).
• Hepatitis (Although not all hepatitis viruses cause hepatomegaly)
• Liver abscess (pyogenic abscess and amoebic abscess)
• Malaria
• Amoeba infections
• Hydatid cyst
• Leptospirosis
• Actinomycosis

Neoplastic

• Metastatic tumours secondary to spread from cancer in other organs (most common)
• Hemangiomas
• Hepatocellular carcinoma
• Myeloma
• Leukemia
• Lymphoma
• hepatoma

Cirrhotic

• Portal
• Biliary
• Cardio
• Haemochromatosis

Metabolic

• Fatty infiltration
• Lysosomal acid lipase deficiency, also known as Wolman disease or cholesteryl ester storage disease
• Amyloidosis
• Gaucher's disease
• Niemann Pick disease
• Von Gierke disease (Glycogen Storage Disease type 1)
• Glycogen Storage Disease types III, VI and IX

Drugs and toxins

• alcoholism
• poisoning.

Congenital

• Hemolytic anemia
• Riedel's lobe is an extended, tongue-like, right lobe of the liver. It is not pathological; it is a normal anatomical variant and may extend into the pelvis. It is often mistaken for a distended gall bladder or liver tumour.
• Polycystic disease
• Cori's disease

Others

• Buddâ€"Chiari syndrome
• Hunter syndrome
• Zellweger's syndrome
• Carnitine palmitoyltransferase I deficiency
• Right ventricular failure
• Granulomatous: Sarcoidosis
• Glycogen storage disease type II