Swollen Liver

What is hepatomegaly?

We speak of hepatomegaly in the presence of an enlarged liver beyond the normal dimensions.

It is a fairly common condition and not necessarily pathological, which can be supported by numerous causes.

The doctor can notice an extremely enlarged liver already from the clinical examination, carrying out certain and precise palpatory maneuvers; ultrasound and various blood tests can subsequently investigate the real causes of the phenomenon.

Symptoms

Often an asymptomatic increase in liver size is due to the accumulation of fat ( steatosis ).

This condition typically appears in middle age when the diet is chronically rich in lipids and high calorie (cheeses, fries, etc.) and when alcohol (wine and beer) and spirits are abused.

Consult the article dedicated to the relationship between nutrition and the liver to find out which foods promote the health of this very important organ.

As for the symptoms, often an enlarged liver does not give any particular sign of itself; only when the volumetric increase is rather rapid and / or showy can the patient experience pain localized in the upper right abdominal region (often it is a simple annoyance, which among other things is not rarely extra-hepatic). However, the pain in the liver can worsen or occur only during palpation of the organ and / or accompanied by a yellowish coloring of the skin and whites of the eyes (jaundice).

Causes

Liver steatosis

excessive accumulation of fat in the liver, which especially in alcoholics can slowly evolve into an inflammatory (hepatitis) with formation of fibrous tissue; typical of the obese, of alcoholics, of type II diabetics and of those who love food excesses (in particular fried foods and foods rich in fat), hepatic steatosis causes hepatomegaly with a soft, smooth and generally painless liver.

Alcoholism

liver diseases are typical of alcoholics.

hepatitis

inflammatory pictures of the liver often of viral origin (as in hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E); they are accompanied by an enlargement of the liver that appears soft, smooth and generally painful in the acute forms, while in the chronic ones the pain arises only in an advanced stage and the organ assumes a hard and knotty consistency.

Liver tumor

at an advanced stage, the tumor mass can increase the size of the organ until it causes pain, making it rather hard on palpation. This disease is typically associated with jaundice, rapid and consistent weight loss, anorexia (lack of appetite), fatigue, nausea and vomiting.

Cirrhosis

chronic and degenerative disease of the liver, in which the normal liver tissue is replaced by a network of scar tissue, among whose meshes nuclei of regenerating hepatocytes can be recognized. Cirrhosis is the natural evolution of many forms of hepatitis not adequately treated, it is typical of alcoholics and some dysmetabolic diseases (non-alcoholic fatty liver disease, glycogen storage disease, hemochromatosis, Wilson's disease). The liver is generally enlarged and in any case hard and nodular; it is accompanied by edema (swelling due to accumulations of diffuse liquids), especially in the abdominal level (ascites, with a swollen and globular abdomen).

Mononucleosis

this infectious disease (kissing disease) is typically accompanied by an enlargement of the liver and spleen; it is generally associated with a strong sense of weakness, fever and pharyngitis (sore throat).

hemochromatosis

disease often on an inherited basis characterized by excessive accumulation of iron in the body; the deposit of the mineral in the liver, in particular, determines an excessive enlargement of the organ; in an advanced stage the skin assumes a bronze / greyish color.

congestive heart failure

if the heart is unable to pump adequate amounts of blood into circulation, the liver may increase in volume due to insufficient blood supply.

OTHER POSSIBLE CAUSES

• other infectious diseases, such as abdominal typhus, infectious brucellosis, rickettsiosis, leishmaniasis, leucetic hepatitis or spirochete hepatitis;
• other metabolic diseases, such as amyloidosis, glycogen storage disease type II and type IV, lysosomal storage diseases;
• haemopathies and lymphomas: chronic myeloid and lymphatic leukemia, haemolytic anemias, Hodgkin's and non-Hodgkin's lymphomas;
• biliary diseases: sclerosing cholangitis; biliary stasis;
• abuse of certain drugs, such as paracetamol (widely used as an analgesic and antipyretic), statins (against high cholesterol), macrolides (antibiotics), amiodarone (anti-arrhythmic drug).

When to worry

The alarm bells that must lead to suspicion of important liver diseases are represented by: jaundice, severe pain in the upper right abdominal region, significant digestive difficulties, showy swellings, loss of appetite, fever accompanied by weakness and rapid weight loss, alterations the color of urine (dark) or faeces (clear).