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Gastroenterology – Hepatomegaly
Whiteboard Animation Transcript
with Kelly Burak, MD
https://medskl.com/Module/Index/hepatomegaly


The normal size of the liver depends on a person’s age, gender, and body habitus. In an adult the liver usually measures 8 – 12 cm in the mid-clavicular line. Enlargement of the liver beyond the normal expected size is termed hepatomegaly.

A palpable liver does not always mean liver pathology. A normal liver can be felt in certain circumstances, such as in really slender individuals or in cases where a respiratory pathology has caused downward displacement of the liver.

The span of the liver should be estimated using percussion to determine the upper border and percussion or palpation to find the lower border.

Hepatomegaly may be a sign of an underlying pathological process. The causes of hepatomegaly are many but can be grouped into the following categories:

Congestive: this may be seen in right heart failure, Budd-Chiari syndrome, and sinusoidal obstructive syndrome.
Infiltrative: this includes benign and malignant causes. Abnormalities in metabolism and storage of substances, such as lipids, glycogen, and protein can lead to enlargement. Non-alcoholic fatty liver disease is the most common, and rarer causes include glycogen storage disorders and amyloidosis. Malignancies can metastasize to the liver and hematologic malignancies, such as lymphoma, can diffusely infiltrate the liver.
Infectious: Hepatitis C and B are common viral infections and Epstein-Barr virus frequently causes hepatosplenomegaly.