Hepatomegaly Causes and Symptoms-liver is enlarged and is swollen
General, Liver

What are the Causes and Symptoms of Hepatomegaly?

Hepatomegaly causes a condition in which the liver is enlarged and is swollen beyond its normal size. The liver is a wedge shaped organ located on the right side of the upper abdomen, and it is the largest internal organ of the body. The functions of the liver are very important to keep the body healthy, and they include the cleansing of blood to remove harmful chemicals manufactured by the body, the secretion of bile juice that helps in the breakdown of fats in food, and the storage of glucose which helps in giving a backup energy boost when the body requires it.

Hepatomegaly may be a sign of a large number of diseases, including the diseases of the liver itself. Hepatomegaly causes could include infections from bacteria, viruses and parasites with certain heart conditions, certain types of leukemia and lymphoma, and certain genetic diseases. The hepatomegaly symptoms are many and depend on the cause of hepatomegaly.

Hepatomegaly Symptoms

Hepatomegaly symptoms are usually the result of the condition that is causing the enlargement of the liver, and the symptoms are accompanied by changes in the digestive system. The most common hepatomegaly symptoms Include:

  • Nausea
  • Vomiting
  • Heartburn that sometimes spreads to the back
  • Bile reflux that triggers the vomiting of bright yellow matter
  • Yellowing of the skin, eyes, and nails caused by jaundice
  • Bloody stools or pale, discolored stools
  • Abdominal pain and discomfort along with the distension of the abdomen
  • Unexplained weight loss
  • Loss of appetite
  • Chronic feeling of fatigue and tiredness
  • Itching
  • Fever in case an infection is the cause for the hepatomegaly

A person experiencing any of the above mentioned hepatomegaly symptoms should consult a doctor immediately.

Tender Hepatomegaly Causes

Tender hepatomegaly is also called large tender liver, and it refers to a condition in which the liver can be palpated and feels tender to the touch. The most common tender hepatomegaly causes include

  • Hepatitis A: This is an infectious form of hepatitis caused by the Hepatitis A virus. Hepatitis is a group of fatal diseases which cause the enlargement of the liver.
  • The Budd Chiari Syndrome: This is a rare condition caused by the occlusion or blockage of the hepatic veins which carry blood from the liver and drain it.
  • Liver Fluke: This is a type of parasite that lives and grows in the liver, and infection from these parasites occurs from eating contaminated or undercooked freshwater fish.
  • Cysts and Abscesses of the Liver: Liver cysts are abnormal fluid-filled cavities that appear in the liver, and liver abscesses mean collections of pus that occur in the liver that is usually caused by bacterial, parasitic, or fungal infections.
  • Typhoid and Paratyphoid Fever: These are systemic infections caused by the bacteria Salmonella Typhi and Salmonella Paratyphi. Typhoid and paratyphoid fevers are collectively called enteric fever.
  • Viral Hepatitis: This is the general name given to several forms of hepatitis including Hepatitis A, Hepatitis B, Hepatitis C, Hepatitis D, and Hepatitis E. Viral hepatitis is often known as infectious hepatitis.
  • Hepatic Hemangiomas: These are non-cancerous or benign masses found in the liver. They are usually made up of blood vessels containing blood and which are tangled, thus forming a mass.
  • Hydatid Cysts: These are cysts that occur in the liver of people with hydatid disease, which is caused by an infection with the larvae of a tapeworm called Echinococcus Granulosus or the dog tapeworm.

Some of the Less common tender Hepatomegaly Causes Include:

  1. The Bearn Kunkel Syndrome: This is a rare autoimmune liver disease that causes liver damage accompanied by the increase of plasma cells and gamma globulin levels in the blood.
  2. Dubin Johnson Syndrome: This is another rare but inherited condition that is characterized by an impairment of bilirubin metabolism resulting in chronic, mild jaundice.
  3. Leukemia: This is the medical term for blood cancer.
  4. Katayama Fever: This is an acute disease caused by an infection with a type of parasite called Schistosoma.
  5. Pylephlebitis: A condition characterized by a pus producing inflammation of the portal vein wall which is responsible for draining blood from the abdominal part of the gastrointestinal tract.

Tender Hepatomegaly Symptoms

The tender Hepatomegaly Symptoms Depend on the causes for tender Hepatomegaly. These Symptoms Include

  • Abdominal pain
  • Ascites or retention of fluid in the abdomen
  • Kidney failure
  • Hives
  • Confusion
  • Lethargy
  • Severe breathing difficulties
  • Delirium and hallucinations
  • Fever higher than 101 Fahrenheit
  • Sudden behavioral changes
  • Headache
  • Anorexia
  • A chronic unproductive cough
  • Bradycardia or slow heart rate
  • Stomach Upset

These tender hepatomegaly symptoms may occur with the other symptoms of hepatomegaly mentioned earlier.

Mild Hepatomegaly Causes

Mild hepatomegaly can result from the same hepatomegaly causes as tender hepatomegaly, but the enlargement of the liver is less pronounced than in tender hepatomegaly. The additional causes of mild hepatomegaly include

  • Fatty Liver: This is a condition characterized by the buildup of fat in the liver, and there are two types of fatty liver disease, i.e. alcoholic fatty liver that is caused by chronic alcoholism and non-alcoholic fatty liver disease whose cause is not known. Fatty liver is also known as hepatic steatosis.
  • Chronic drug and alcohol abuse
  • Hemochromatosis: A condition characterized by excess iron in the body
  • Moderate Stages of Liver Cirrhosis: Cirrhosis is a condition which is characterized by the fibrosis or scarring of the liver tissue caused by diseases such as hepatitis and other factors such as alcoholism.

However, mild hepatomegaly may sometimes be a normal finding in children.

Mild Hepatomegaly Symptoms

The symptoms of mild hepatomegaly are the same as the hepatomegaly symptoms mentioned earlier, and the severity of the symptoms depends on the hepatomegaly cause and its severity.

Massive Hepatomegaly Causes

The Most Common Causes of Massive Hepatomegaly include

  • Cancer that may primarily arise in the liver or that may have metastasized or spread to the liver from other body parts
  • Right sided heart failure
  • Myeloproliferative disorders which mean a group of diseases that cause an abnormal growth of all types of blood cells including WBCs, RBCs, and Platelets in the bone marrow
  • Liver diseases such as fatty liver and cirrhosis caused by alcoholic or non-alcoholic factors
Medically Reviewed By
Dr. Kaushal M. Bhavsar (MBBS, MD)Assistant Professor in Pulmonary Medicine, GMERS Medical College, Ahmedabad