Organomegaly

Organomegaly is the enlargement of an organ beyond its normal size, determined by clinical examination or imaging. The term is most often applied to the liver (hepatomegaly) and the spleen (splenomegaly), but any organ can be enlarged. True organomegaly results from mechanisms such as cellular hyperplasia or hypertrophy, infiltration by abnormal substances (for example storage diseases or malignancy), vascular congestion, or edema.

Causes of organomegaly are varied and location-specific. Common contributors include liver diseases such as hepatitis, fatty liver disease, cirrhosis, and portal hypertension; congestive heart failure; infections; inflammatory or autoimmune disorders; storage or metabolic diseases (for example, certain lysosomal storage disorders); hematologic malignancies and other infiltrative or metastatic processes; and conditions causing splenic sequestration or congestion. In children, physiologic enlargement can occur with growth, while congenital or metabolic disorders may cause early or progressive organ enlargement.

Evaluation begins with a detailed history and physical examination, followed by laboratory testing (for example, complete blood count, liver function tests, inflammatory markers) and targeted imaging. Ultrasound is typically the first imaging modality to define organ size and structure; CT or MRI and, when indicated, radionuclide studies can provide further detail. Clinicians differentiate true organomegaly from apparent enlargement due to factors such as obesity or abdominal distension, and they assess for accompanying clues such as tenderness, nodes, or ascites.

Management focuses on the underlying cause. Treatment may involve antiviral or immunosuppressive therapy, management of heart failure or portal hypertension, or outcomes-focused care for storage diseases or malignancy. Some cases of organomegaly resolve with appropriate therapy, while others require ongoing monitoring and supportive care.