Hepatomegaly

Changed by Matt A. Morgan, 6 Mar 2015

Updates to Article Attributes

Body was changed:

Show markup changes

Hepatomegaly refers to an increase in size or enlargement of the liver.

Pathology

Aetiology

Hepatomegaly can result from a vast range of pathology including, but not limited to, the following:

malignancy/cellular infiltrate
- multiple metastases
- lymphoma(s)
- leukaemia(s)
- hepatocellular carcinoma
- extramedullary haematopoiesis
- systemic mastocytosis
acquired hepatic conditions
- fatty infiltration
- cirrhosis - early
- secondaryhaemochromatosis
- hepatic amyloidosis
- hepatic veno-occlusive disease
- sarcoidosis
- infectious mononucleosis
- primary biliary cirrhosis
acquired non hepatic conditions
- right heart failure
congenital anomalies
- biochemical
  - glycogen storage disease
  - primary haemochromatosis
  - Gaucher's disease
  - certain mucopolysaccharidoses - e.g. Hunter syndrome
  - Niemann-Pick disease
- anatomical
  - biliary atresia
syndromes
- Zellweger syndrome

Radiographic features

Assessment of liver size in commonly made on ultrasound or CT, although gross hepatomegaly may be apparent on ~~plain film imaging~~abdominal radiograph.

AFor the adult liver:

midclavicular line averages 10-12.5 cm in craniocaudal length ²
- a liver that is longer than 15~~.5cm~~.5 cm in the ~~mid-clavicular~~midclavicular line is considered enlarged~~, however in~~

average transverse diameter is 20-23 cm at the area of the upper pole of the right kidney ²

In practice, however, assessment is often subjective.

Features that support hepatomegaly include ¹:

extension of the right lobe inferior to the lower pole of the right kidney
rounding of the hepatic inferior border

Differential diagnosis

Riedel's lobe (normal variant)

~~-<li>secondary<a href="/articles/haemochromatosis"> haemochromatosis</a>~~
+<li>secondary <a href="/articles/haemochromatosis">haemochromatosis</a>
~~-<li>infectious mononucleosis</li>~~
+<li><a title="Infectious mononucleosis" href="/articles/mononucleosis">infectious mononucleosis</a></li>
-</ul><h4>Radiographic features</h4><p>Assessment of liver size in commonly made on ultrasound or CT, although gross hepatomegaly may be apparent on plain film imaging.</p><p>A liver that is longer than 15.5cm in the mid-clavicular line is considered enlarged, however in practice assessment is often subjective. Features that support hepatomegaly include <sup>1</sup>:</p><ul>
+</ul><h4>Radiographic features</h4><p>Assessment of liver size in commonly made on ultrasound or CT, although gross hepatomegaly may be apparent on abdominal radiograph.</p><p>For the adult liver:</p><ul>
+<li>midclavicular line averages 10-12.5 cm in craniocaudal length <sup>2</sup><ul><li>
+<sup></sup> a liver that is longer than 15.5 cm in the midclavicular line is considered enlarged</li></ul>
+</li>
+<li>average transverse diameter is 20-23 cm at the area of the upper pole of the right kidney <sup>2</sup>
+</li>
+</ul><p>In practice, however, assessment is often subjective.</p><p>Features that support hepatomegaly include <sup>1</sup>:</p><ul>
~~-<a href="/articles/riedel-lobe-1">Riedel's lobe</a> (normal variant)</li></ul><h4>See also</h4><ul><li><a href="/articles/hepatosplenomegaly">hepatosplenomegaly</a></li></ul>~~
+<a href="/articles/riedel-lobe-3">Riedel's lobe</a> (normal variant)</li></ul><h4>See also</h4><ul><li><a href="/articles/hepatosplenomegaly">hepatosplenomegaly</a></li></ul>

References changed:

2. Kennedy PA, Madding GF. Surgical anatomy of the liver. Surg. Clin. North Am. 1977;57 (2): 233-44. <a href=http://www.ncbi.nlm.nih.gov/pubmed/322332">Pubmed citation</a><span class="auto"></span>

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":24805,"studyId":7645,"caseSlug":"hepatomegaly-abdominal-x-ray","caption":"Case 1: hepatomegaly on abdominal radiograph","thumbnail":"https://prod-images-static.radiopaedia.org/images/24805/939d1af5664251cbc76bfea4c69d85_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"probable"},{"imageId":25420,"studyId":7771,"caseSlug":"hepatomegaly-1","caption":"Case 2 ","thumbnail":"https://prod-images-static.radiopaedia.org/images/25420/f4ad43586abb20167ec3ac23438ee0_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":381457,"studyId":9874,"caseSlug":"chronic-myeloid-leukemia-with-splenic-infarction","caption":"Case 3: CML with hepatosplenomegaly","thumbnail":"https://prod-images-static.radiopaedia.org/images/381457/6e170bb3a3db9f0dd82c3836018f7a_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":5610384,"studyId":27139,"caseSlug":"hepatomegaly-with-multiple-secondaries","caption":"Case 4: due to metastases","thumbnail":"https://prod-images-static.radiopaedia.org/images/5610384/41e309b9946540d901375fe0bc8dd3_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":7464736,"studyId":30407,"caseSlug":"paraganglioma-liver-and-bone-metastases-2","caption":"Case 5: metastases displacing bowel inferiorly","thumbnail":"https://prod-images-static.radiopaedia.org/images/7464736/aedeac7abbbd6ade55fa02b05e5e13_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":8641635,"studyId":32334,"caseSlug":"splenic-infarction-9","caption":"Case 6: myelofibrosis","thumbnail":"https://prod-images-static.radiopaedia.org/images/8641635/050976ebd507c82f15bdfcd2d9ec7d_big_gallery.jpg","isStack":true,"diagnosticCertainty":"confirmed_unsubstantiated"},{"imageId":53786813,"studyId":98956,"caseSlug":"hepatomegaly","caption":"Case 7","thumbnail":"https://prod-images-static.radiopaedia.org/images/53786813/h_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"}],"ddx_inclusions":[{"imageId":3441428,"studyId":23166,"caseSlug":"riedel-lobe-3","caption":"Riedel lobe","thumbnail":"https://prod-images-static.radiopaedia.org/images/3441428/7772f635554c5f1b565fa6523330f3_big_gallery.jpg","isStack":false,"diagnosticCertainty":"confirmed_substantiated"},{"imageId":63068463,"studyId":139685,"caseSlug":"beaver-tail-liver-14","caption":"Beaver tail liver","thumbnail":"https://prod-images-static.radiopaedia.org/images/63068463/954c1bf1b56ecb7ac0d8ff13068b8a34296c3ddb6dc41b2e87d525c5ae77b52b_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"confirmed_substantiated"}],"lang":"us"}