What is Hepatomegaly?
This condition occurs when your liver becomes enlarged. Your liver is located in your upper right quadrant of the abdomen and is shaped like a football. A normal liver is approximately ten point five centimeters in men and in women it is approximately seven point five centimeters but can be three centimeters smaller or larger. What it weights and the size will increase with your body weight and age. Your body shape and gender will also play a part in the size of the liver. Hepatomegaly is not a disease but is considered a symptom of many different liver diseases and it relates to your liver having the inability to handle the production and flow of your bile and the ability to make important clotting factors and store glycogen.
Some of the symptoms of enlargement of the liver are unnoticeable or mild so it is not often diagnosed when it first begins. Because your liver does not have any nerve endings it does not send any signals or impulses to your brain that something is wrong with your liver until Hepatomegaly occurs.
When your liver begins to exert pressure on the organs around it because of its enlargement you may begin to experience:
- Discomfort and pain in your abdomen
- Feeling full
- Tenderness and pain in the upper right part of your abdomen
- A distended abdomen
- Flank pain on the right side
- Jaundice which is when your skin and eyes begin to look yellow because the bile is blocked.
- Color urine may change
- Feet and legs may swell
- Vomiting blood
- You may have black tarry stools from the blood that has broken down in the intestines and stomach
- Bruising easily because the production of clotting factors have decreased
- Shortness of breath that could be associated with pericarditis or congestive heart failure
- Loosing weight
The main cause of Hepatomegaly is excessive consumption of alcohol also referred to as alcoholic hepatitis. Other causes of this may include:
- Congestive heart failure
- Hepatitis A, B, or C
- Hereditary fructose intolerance
- Infectious mononucleosis
- Reye’s syndrome
- Metastatic cancer which is where the cancer cells have spread to your liver from another part of your body.
- Cirrhosis of the liver which is when you have scarring and hardening of your liver tissues.
- Obstruction of your gall bladder or bile ducts.
- Gaucher’s Disease which is when fatty substances build up in the liver.
- Hemachromatosis which is when iron builds up in the liver.
- Wilson’s Disease which is when copper builds up in your liver.
- Cysts that are filled with fluid.
- Malignant growths in your liver.
It can also be caused by any disease that causes an infection in your liver that disturbs the blood flow and cause the live to become infiltrated with malignant or benign tumors. These tumors can add mass to your liver and increase the size.
The symptoms may not very conspicuous so the diagnosis may be difficult. The physicians will look at the medical history of the patient and do a physical examination by:
- Palpation which is when the physician tries to feel the size, location, texture, and shape of your liver.
- Percussion is when the physician taps their fingers over the affected parts of your body to see if they can feel the liver. Under normal circumstances the physician will not be able to feel your liver below the lower edge of your ribs but if he can feel the lower edge with their fingertips they will order more testing.
- Auscultation which is when the physician listens to the sounds in your liver and abdomen using a stethoscope.
The physician may also order the following tests:
- X-ray of your abdominal area
- Abdominal ultrasound if during a physical exam the physician thinks the liver feels enlarged in order to confirm the condition or diagnosis.
- CT scan of your abdomen
- Liver function tests that may include tests to see how your blood clots
- MRI scan of your abdomen
If necessary they may do a liver biopsy to find out the cause of enlargement.
Because Hepatomegaly could be a symptom of many different medical conditions the treatment that is used will depend on what the underlying cause is. Because one of the main causes is excessive alcohol consumption a person will need to refrain from consuming any alcohol. They will also need to make sure that they are eating a healthy diet. A person may also need to take medication if the cause could be hepatitis, diabetes mellitus, etc. You will also need to keep a close watch on your weight because being obese can cause liver enlargement. If it is cancer the physician may use radiation and chemotherapy.
If the underlying condition is not diagnosed and treated it can be fatal.