What causes liver enlarged? 5 possible conditions

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Your liver is shaped somewhat like a football and is located in the upper right quadrant of your abdomen below your diaphragm and between your right nipple and the last rib on your right side. The liver is usually about 7.5 centimeters in women and 10.5 centimeters in men. It may be 3 centimeters larger or smaller and still be normal.

The size and weight of your liver increases with your age and body weight. Sex and body shape also influence the size of your liver.

Hepatomegaly is the enlargement of your liver. An enlarged liver is a sign that something is seriously wrong with your health. Hepatomegaly is always a cause for medical evaluation, although not all of the underlying conditions that cause it are medical emergencies.


Your liver is a very hearty organ that is able to grow back even after large portions of it have been surgically removed. It performs many functions that are essential to your health. Liver cells produce bile, a yellowish green liquid that helps you digest fats. Your liver also stores glucose in the form of glycogen. If you do not eat enough, your liver releases glucose into your blood to keep your brain and other organs functioning.

Diseases that cause hepatomegaly can severely interfere with your liver’s ability to function normally. Many of the symptoms and dangers of diseases that cause hepatomegaly relate to the inability of your liver to handle bile production and its flow, as well as impairments such as the ability to store glycogen and make important clotting factors.

Common Causes of Hepatomegaly

Diseases that cause infection of your liver disturb the blood flow and cause your liver to become infiltrated with benign or malignant tumors. They add mass to the liver, thereby increasing its size. According to MedlinePlus, the most common causes of hepatomegaly are:

  • metastatic cancer (where cancer cells have spread from other parts of the body)
  • congestive heart failure
  • lymphoma
  • alcoholic hepatitis
  • fatty liver caused by total parenteral nutrition (TPN)
  • cirrhosis

Some other causes of hepatomegaly are:

  • infectious hepatitis (hepatitis A, B, or C, or mononucleosis)
  • toxic hepatitis
  • obstruction of your bile ducts or gall bladder
  • Gaucher’s disease (a disorder that causes fatty substances to build up in your liver)
  • hemachromatosis (a disease that causes iron to build up in your liver)
  • Wilson’s disease (a disease that causes copper to build up in your liver)
  • fluid-filled cysts

Symptoms Associated With Hepatomegaly

All of the symptoms associated with hepatomegaly are serious. You should see your doctor if you have any of the following symptoms:

  • jaundice (yellowing of the skin and eyes caused by the blockage of bile)
  • fatigue
  • itching
  • nausea
  • vomiting
  • abdominal pain or fullness
  • swelling of the feet and legs
  • easy bruising (caused by decrease production of clotting factors)
  • vomiting blood
  • black tarry stools (actually blood that has been broken down in the stomach and intestines)
  • shortness of breath (associated with congestive heart failure and pericarditis)
  • weight loss

Nausea, vomiting (with or without blood), abdominal pain, tarry stools, and shortness of breath are medical emergencies.

What to Expect From the Doctor

A complete medical history and physical exam are the first steps to finding the reason why your liver is enlarged.


To find out why you have hepatomegaly, your doctor may order a variety of tests, such as:

  • CBC (complete blood count to evaluate general health)
  • liver enzymes
  • abdominal X-ray (noninvasive X-ray study that serves as a quick, initial evaluation of abdominal organs)
  • CAT scan of the abdomen (X-rays obtain high resolution images of the liver and other abdominal organs to evaluate liver size.) (Wolf, 1990).
  • MRI of the abdomen (magnetic resonance to make high resolution images of the abdominal organs)
  • Ultrasound of the abdomen (sound waves to evaluate the liver and other abdominal organs)
  • liver biopsy (an invasive test that takes a small sample of liver for microscopic examination to make a diagnosis)


The underlying disorders that cause your liver to be enlarged determine your treatment options. Congestive heart failure can be treated with medications. Treatment options for liver cancer include chemotherapy, surgery, and liver transplant. Metastatic cancer is treated according to the source of the cancer. Treatment options for lymphoma depend upon the type, stage (degree of spread), and your general health.

Long-Term Consequences of Non-Treatment

Failure to diagnose and treat the underlying cause of hepatomegaly can be fatal.


There are many common-sense measures you can take to protect your liver. Some of the things you can do are:

  • Exercise caution when drinking alcohol and consider not drinking at all. Discuss your drinking habits with your doctor to see if your intake is excessive.
  • Take vitamin supplements only as directed, and always discuss them with your doctor.

Exercise caution in taking herbal supplements. Always discuss any herbs you are considering taking with your doctor. According to the MayoClinic, (2012), herbs that can damage your liver include: black cohosh, chaparral

comfrey, germander, ma-huang, skullcap, kava, mistletoe, valerian, and pennyroyal

  • Eat a balanced diet containing whole grains, vegetables, and fruit.
  • Maintain an optimal weight.
  • Stop smoking.

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See a list of possible causes in order from the most common to the least.



Cholesterol is a waxy substance that occurs naturally in the body. But too much cholesterol can clog blood vessels and lead to heart attack or stroke.

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Familial Combined Hyperlipidemia

Familial combined hyperlipidemia is an inherited disorder that causes high cholesterol and high levels of triglycerides. Some individuals have no physical symptoms from the disease. For others, it may cause chest pain.

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Adult-Onset Still's Disease

This relatively rare inflammatory condition begins with fever and may lead to arthritis. Women and people between the ages of 16 and 46 are most at risk.

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Hyperlipoproteinemia Type IV

Hyperlipoproteinemia type IV leads to higher-than-normal triglyceride level due to a genetic defect. This may cause atherosclerosis and increase risk for certain heart conditions, including coronary artery disease.

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Hyperlipoproteinemia is a common disorder that results in high levels of lipids circulating in the blood. This can cause pancreatitis, abdominal pain, enlarged liver and other symptoms.

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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