hepatomegalia

Hepatomegaly, also known as hepatomegalia, is the abnormal enlargement of the liver. Clinically, it is suggested when the liver edge extends below the right costal margin or when imaging shows increased liver size. It is a sign, not a disease, and arises from a wide range of acute and chronic conditions.

Common causes are grouped into congestive or vascular conditions (for example heart failure with hepatic congestion or Budd-Chiari syndrome), metabolic and toxic disorders (such as nonalcoholic fatty liver disease, alcoholic liver disease, and cirrhosis), infections (including viral hepatitis), infiltrative or storage diseases (amyloidosis, hemochromatosis), and neoplasms or drug-induced liver injury.

Symptoms vary. Many individuals are asymptomatic; others report fullness or dull pain in the right upper abdomen, early satiety, or discomfort that may radiate to the shoulder. Signs include a palpable liver edge and, depending on the cause, jaundice, fluid accumulation, or stigmata of chronic liver disease.

Evaluation starts with history and examination, followed by laboratory tests (liver enzymes, bilirubin, albumin, INR) and imaging. Ultrasound is typically first-line; CT or MRI may be used for further characterization. In selected cases, liver biopsy or elastography helps establish cause and stage.

Management targets the underlying condition. This may involve lifestyle modification, antiviral or anti-inflammatory therapy, management of heart failure or metabolic disease, or, in progressive cases, consideration of liver transplantation. The prognosis depends on the etiology and reversibility of the liver enlargement.