Enlarged liver – causes and liver diseases
The simple palpation or inspection may reveal an enlarged liver. An enlarged liver, usually occurs in a disease that overloads the liver which is the main body metaboliser. The liver increases by hyperfunction and storage of metabolites.
Correct palpation of the liver is made by the practitioner, but an enlarged liver can be easily revealed by the patient.
The term of hepatomegaly defines an enlarged liver. This is generally detected subcostal right, but may occupy all the upper abdominal part. Generally, the liver does not exceed more than 2-3 cm the last right rib (except children).
Enlarged liver causes and symptoms of liver disease
– Cirrhosis – the liver is irregular, hard, painless, with a sharp lower edge.
– Hepatitis – in acute hepatitis the palpable surface is smooth (regular), the liver is resilient, but with liver pain. In chronic hepatitis liver is firm and with moderate pain.
– Liver abscess or hydatid cyst – the liver appears enlarged, irregular, painless, with consistency like a water pillow.
– In benign liver tumors or liver cancer – the bottom edge is nodular, an enlarged liver with very hard consistency, irregular surface, liver pain on palpation.
– In steatosis, amyloidosis, glicogenosis – the liver is large, firm, painless, with rounded bottom edge. Hepatic steatosis (fatty liver) is an infiltration of the liver with fat which may be due to alcohol consumption (alcoholic steatohepatitis) or a severe dyslipidemia (non-alcoholic steatohepatitis). These are the two main causes of fatty liver.
– In right heart failure appears an enlarged liver caused by retrograde vascular stasis. Vascular stasis hepatomegaly cause an enlarged liver with rounded bottom edge, liver pain, smooth surface and elastic consistency. Symptoms of enlarged liver: swelling of jugular veins.
– In biliary obstruction (eg choledocholithiasis) or cancer of head of pancreas: large liver, rounded bottom edge, smooth surface, firm liver, with pain on palpation and with jaundice as associated symptom.
– Hepatomegaly (enlarged liver) can occur in association with an enlarged spleen: symptoms in diseases like lymphoma and leukemia.