What is liver enlargement?
Liver is a vital organ located on the upper right abdomen. It clears toxins from the body and enables clotting of blood.
Liver enlargement, or hepatomegaly as it is known in medical terms, refers to swelling of the liver beyond its normal size. An enlarged liver is not a disease by itself; it is a sign of an underlying condition like hepatitis, liver disease, and cancer or heart problem. Treating the actual condition controls liver enlargement.
What are the causes of the disorder?
Liver enlargement may occur as a result of the following conditions:
- Fatty liver or inflammation – An inflamed liver may result from an abscess or viral infection, toxins, certain liver conditions like hepatitis or alcoholic hepatitis, medications, autoimmune disease or a genetic disorder that causes accumulation of fat and protein in the body.
- Abnormal growth – An enlarged liver may result from cysts or tumours that begin elsewhere but spread to the liver. These include leukaemia, lymphoma or liver cancer.
- Restricted blood flow to liver – Problems in the heart and blood vessels can cause liver enlargement. These include:
o Congestive heart failure (heart is unable to pump blood)
o Pericarditis (Inflammation of tissue surrounding the heart)
o Heart failure
o Blockage of veins that drain in the liver (Budd-Chiari syndrome, Hepatic vein thrombosis, Veno-occlusive disease)
What one needs to know about symptoms or signs?
Many cases of liver enlargement do not display symptoms. Severe cases of hepatomegaly may show:
- Abdominal discomfort
- Feeling of fullness
- Fatigue, weakness
- Weight loss
Which specialist should be consulted in case of signs and symptoms?
A person experiencing the above symptoms must consult a hepatologist, a specialist in treating liver ailments.
What are the screening tests and investigations done to confirm or rule out the disorder?
A doctor conducts a physical exam to look for swelling in the right side of abdomen. Confirmatory diagnosis is made through the following tests:
- Blood tests (to look for liver disease and abnormal levels of liver enzymes)
- Magnetic resonance imaging (MRI)
- Ultrasound (to view the liver)
- Computed tomography (CT) scan
- Endoscopic retrograde cholangiopancreatography (ERCP) (looks for problems in the bile duct using a scope)
- Magnetic resonance cholangiopancreatography (MRCP) (specialized MRI to look inside the bile duct)
- Liver biopsy (to examine a sample of liver tissue for signs of fatty liver or cancer)
What treatment modalities are available for management of the disorder?
If left untreated, an enlarged liver can cause liver failure. The doctor conducts tests to find out the underlying cause and then take measures to control it. For example, drinking alcohol in excess causes an alcoholic hepatitis. Stopping alcohol consumption is a step in countering the liver swelling that results from it.
How can the disorder be prevented from happening or recurring?
Following some simple measures can prevent liver enlargement or liver disease:
- Eating a healthy diet
- Drinking alcohol in moderation
- Quitting smoking
- Maintaining a healthy weight
- Taking medication and supplements under doctor’s guidance and within the recommended dosage
“Enlarged Liver (Hepatomegaly)” WebMD.com, https://www.webmd.com/hepatitis/enlarged-liver-causes
“Enlarged liver,” MayoClinic.com, Mayo Clinic Staff, https://www.mayoclinic.org/diseases-conditions/enlarged-liver/basics/causes/con-20024769
“Hepatomegaly,” MedlinePlus, NLM, NIH, https://www.nlm.nih.gov/medlineplus/ency/article/003275.htm
“Hepatomegaly,” Patient.co.uk, https://www.patient.co.uk/doctor/hepatomegaly
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