The enlarged liver or enlarged liver is the growth of the liver beyond normal size. Depending on the person, gender, age, height, and weight, the size of the liver can vary. This is an organ of the digestive system whose function is to help in the digestive process and cleanse the blood by eliminating harmful chemicals produced by the body.
Among other functions, it stands out to produce liquid bile, which helps to break down fat in food into energy; it also stores sugar, known as glucose. More than a disease, an enlarged liver is a symptom of a larger problem, such as liver disease, congestive heart failure, or cancer.
A swollen liver is not usually a symptom that the patient can feel; It is usually accompanied by other more prominent symptoms that may indicate a serious liver condition. The most prominent clinical sign is abdominal pain in the right upper quadrant (location of the liver from the topographical point of view in the abdomen).
This is so because, as the liver increases in size, it compresses the capsule of connective tissue that surrounds it, which contains many nerve endings, stimulated by stretching and activating the somatosensory pathway of pain.
Hepatomegaly can go unnoticed for a long time and can sometimes be detected with a routine physical exam, when the doctor presses on the right side of the abdomen to feel the size of the liver and check for tenderness.
However, to know for sure the magnitude of the problem, an ultrasound, a computed tomography and / or an MRI is necessary. Any of these studies allows us to observe other structures related to the functioning of the liver.
Some of these structures are the bile duct (where the liver excretes bile, necessary for digestion and detoxification of certain substances), the portal vein that brings nutrients from intestinal digestion and absorption, and the hepatic arteries and veins. These structures may be altered, which could guide the diagnosis.
Symptoms
In a large number of cases, if the patient has an enlarged liver, they will not notice any symptoms. Other times the patient may feel fatigue, weakness, and mild abdominal discomfort. Due to excess fat and inflammation, the patient often loses their appetite, leading to weight loss and weakness.
Other symptoms that a person with hepatomegaly may experience are the following:
-Pain in the belly, upper right side.
- Easy bruising, due to the liver being the organ responsible for producing blood clotting factors.
- Muscle pains.
- Diarrhea.
- Nausea.
- Jaundice or yellowing of the skin and eyes, due to the accumulation of bilirubin in the blood, which is metabolized in the liver and excreted in the bile.
-Abdominal swelling.
-Bleeding of the gums, due to the deficit of coagulation factors.
-Clay colored stools, a very characteristic sign of hepatomegaly in cases in which the bile duct is obstructed (the liver is enlarged by accumulation of bile components); This is because the bile confers the characteristic copper color to the stool.
Causes
Hepatomegaly or enlarged liver is usually caused by liver disorders related to excessive alcohol consumption, congestive heart failure, glycogen storage disease, viral hepatitis, liver cancer, and steatosis (also known as fatty liver).
Cancer from other tissue may also be a factor, as the liver is a frequent target for tumor metastases due to its rich vasculature.
According to various research, approximately 25% of Americans suffer from fatty liver disease or accumulation of fat in the liver.
Other common causes of an enlarged liver include the following:
-Metastatic cancer or cancer originating in different organs, which spreads to the liver.
-Heart and blood vessel abnormalities, or conditions that can block the veins that drain the liver.
-Liver cancer, leukemia or lymphoma.
-Cirrosis or advanced liver damage caused by toxins.
-Hepatitis caused by a virus, including hepatitis A to hepatitis G. Many other viruses affect the liver, such as the Epstein-Barr virus (mononucleosis), or cytomegalovirus in the case of patients with a depressed immune system.
-Alcoholic liver disease or a range of liver damage that includes fatty deposits, inflammation and scarring in the liver, caused by excessive alcohol consumption.
-Wilson disease, which causes copper to accumulate in the liver.
-Amyloidosis, a disorder that accumulates abnormal proteins in many parts of the body, including the liver.
-Hemochromatosis, a disorder that causes iron to accumulate in the liver.
-Obstruction of the gallbladder or bile ducts.
-Medicines, the leading cause of hepatitis in developed countries. The main drug involved is acetaminophen or paracetamol, whose function is to relieve pain and fever. However, as it passes through the liver, it is metabolized into a highly toxic substance for this organ; its excessive consumption can even be lethal in some patients.
Treatments
Treatment of enlarged liver or hepatomegaly usually varies depending on the cause of it. Many of the causes, such as alcoholic hepatitis and nonalcoholic fatty liver disease, can improve with a healthier lifestyle, regulating or abstaining from alcohol, and eating a healthier diet.
In the case of nonalcoholic fatty liver, there is very little that can be done to reverse the damage done, beyond taking steps to prevent the disease from progressing. In many cases, these patients must opt for liver transplantation as the only curative measure.
For cases such as liver failure or infections such as hepatitis C, medications and treatments will be recommended that will attack the root of the problem.
In cancer, chemotherapy, surgery or radiation will be the main treatment. In extreme situations, a liver transplant may be recommended.
References
- Dr. Victor Marchione, (2018), Enlarged liver (hepatomegaly) from fatty liver disease or inflammation leads to swelling, fatigue, and weakness, Bel Marra Health: belmarrahealth.com
- What is enlarged liver ?, (2016), Health Grades: healthgrades.com
- Verneda Lights and Rachel Nall, (2016), What Causes Liver Enlarged ?, Health Line: healthline.com
- Enlarged liver, (2018), Mayo Clinic: mayoclinic.org
- Katherine Neal, Snehal Patel, Sf, Hepatomegaly, The Clinical Advisor: clinicalaíritu.com
- Enlarged Liver (Hepatomegaly), (2017), Web MD:.webmd.com