Mechanism

The mechanism of hepatomegaly consists of vascular swelling, inflammation (infectious in origin), and deposition of (1) non-hepatic cells or (2) increased cell contents (such as that due to iron in hemochromatosis or hemosiderosis and fat in fatty liver disease).

Diagnosis

thumb|[[Abdominal ultrasonography of the liver, as a sagittal plane through the midclavicular line, with some standard measurements]]

thumb|140 px|Right lobe of the liver at the [[midclavicular line at ages 0 to 7]]

Suspicion of hepatomegaly indicates a thorough medical history and physical examination, wherein the latter typically includes an increased liver span.

On abdominal ultrasonography, the liver can be measured by the maximum dimension on a sagittal plane view through the midclavicular line, which is normally up to 18 cm in adults.

Workup

Blood tests should be done, especially liver-function tests, which give a good impression of the patient's broad metabolic picture.

A complete blood test can help distinguish intrinsic liver disease from extrahepatic bile-duct obstruction. An ultrasound of the liver can reliably detect a dilated biliary-duct system,

it can also detect the characteristics of a cirrhotic liver.

Computerized tomography (CT) can give accurate anatomical information for a complete diagnosis.

Treatment

[[File:Prednisone2.png|140 px|thumb|left|

Prednisone]]

Treatment of hepatomegaly varies with the cause, so accurate diagnosis is the first concern. In auto-immune liver disease, prednisone and azathioprine may be used for treatment.

In lymphoma the treatment options include single-agent (or multi-agent) chemotherapy and regional radiotherapy, and surgery is an option in specific situations. Meningococcal group C conjugate vaccine is used in some cases.

In primary biliary cirrhosis, ursodeoxycholic acid helps the bloodstream remove bile, which may increase survival.

See also

  • Hepatosplenomegaly
  • Liver function tests

References

Further reading

  • Merck Manual: Hepatomegaly