Enlarged liver

Definition

The enlarged liver, also known as hepatomegaly, is not a clinical disease, but it is the enlargement of the liver more than its standard size for the age and sex of the individual. 

Different medical conditions can cause the liver to enlarge, which can be measured accurately with an abdominal ultrasound.

Causes and Risk Factors

• Virus infections, e.g. Hepatitis A, B, C and D.
• Other liver viral infections include yellow fever, dengue fever, cytomegalovirus (CMV), and Epstein-Barr virus (EBV).
• Fatty liver disease and alcoholic fatty liver disease
• Nonalcoholic fatty liver disease
• Metabolic conditions causing the accumulation of substances in the liver tissue also affect the size of the liver, causing hepatomegaly. Common metabolic disorders include: Wilson’s disease ( the accumulation of excessive copper within the cells of the liver), hemochromatosis (collection of iron in the liver), Gaucher’s disease (it causes the accumulation of fatty substances within the liver) and amyloidosis ( a disorder that causes the deposition of abnormal protein in the liver)
• Autoimmune disorders in which the immune system directly attacks the cells of the liver, causing inflammation and swelling of the liver
• Hepatocellular cancer and secondary metastatic tumours to the liver can also cause liver enlargement.
• Other non-malignant liver tumours like hemangioma (tumours arising from the wall of blood vessels) and adenoma
• Congestive cardiac failure and chronic renal disease increase the amount of fluid in the body leading to the accumulation of such fluid in the liver.
• Obstruction of the hepatic vein from Hepatic vein thrombosis or compression by other abdominal organs will lead to an impairment in the amount of blood flowing out from the liver leading to the accumulation of blood within the liver’s tissue.

Symptoms

• Non-specific symptoms like anorexia, nausea and vomiting, weight loss and wasting of muscles
• Abdominal distension and bloating, easy satiety from small helpings of food
• Generalized body weakness
• Jaundice may also occur, which is the yellowish discolouration of the body’s skin, sclera and mucus membranes caused by an increase in the blood level of bilirubin.
• Anaemia and pallor may also occur.
• Symptoms related to the specific disease condition causing the hepatomegaly

Complications

• Liver failure with end-stage liver damage
• Disorders in the metabolism of carbohydrate, fat and protein
• Hepatorenal syndrome which is the presence of renal damage associated with end-stage liver failure
• Hepatic encephalopathy is the affectation of the brain seen in a patient with hepatic failure. Such presents with confusion, disorientation, poor memory, abnormalities of speech and writing, seizures, coma and death
• Certain conditions causing hepatomegaly may later lead to cirrhosis and shrinkage of the liver.
• Severe bleeding
• Increase risk of infections