Enlarged Liver and Spleen

Introduction

What is enlarged liver and spleen?

An enlarged liver and spleen, medically known as hepatosplenomegaly, occur when the liver and spleen swell beyond their normal size.

The liver is a large accessory organ in the digestive system, responsible for a number of functions including bile secretion to break down food, storage of iron and vitamins, production of blood proteins, and elimination of old red blood cells. Many medications are also metabolized through the liver. The liver is located in the upper-right quadrant of the abdomen, with the lower edge connecting to the lower edge of the rib cage. The body’s entire blood volume circulates through the liver approximately six times per minute, an enormous amount of fluid.

Normally, you would not be able to feel your liver, except, perhaps, when you take a deep breath. However, an enlarged liver can be easily palpated (felt) by your health care provider during an exam. The condition of having an enlarged liver is known as hepatomegaly.

The spleen is part of the lymphatic system, which plays a role in immunity and maintenance of healthy blood cells. It is an important organ and is affected by disorders of the blood, liver, and immune system. An enlarged spleen is known as splenomegaly.

Although hepatosplenomegaly often produces no symptoms, it is known to cause abdominal pain in the upper portion of your abdomen. S eek prompt medical care if upper abdominal pain is persistent and its severity increases upon taking deep breaths or eating.

Symptoms

What other symptoms might occur with enlarged liver and spleen?

Hepatosplenomegaly may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. The condition may not always present with symptoms, but may be detected by your health care provider upon examination.

Other symptoms that may occur along with enlarged liver and spleen

Enlarged liver and spleen may accompany other symptoms including:

Symptoms that might indicate a serious condition

In some cases, enlarged liver and spleen may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have enlarged liver and spleen along with other serious symptoms including:

  • Confusion or loss of consciousness for even a brief moment
  • High fever (higher than 101 degrees Fahrenheit)
  • Severe abdominal pain
  • Yellowing of the skin and whites of the eyes (jaundice)
Causes

What causes enlarged liver and spleen?

Enlarged liver and spleen has a variety of causes including infections, blood disorders, liver disease, and cancers.

Infectious causes of enlarged liver and spleen

Enlarged liver and spleen may be caused by infections including:

Hepatic (liver) causes of enlarged liver and spleen

Enlarged liver and spleen can also be caused by hepatic (liver) disorders including:

  • Biliary atresia (blockage in the tubes that transport bile from the gallbladder to the liver)

  • Cirrhosis (scarring of the liver)

  • Hepatocellular carcinoma (tumor of the liver cells)

  • Portal hypertension (high blood pressure in the portal vein, which supplies blood to the liver)

  • Portal vein obstruction (obstruction of the portal vein, which supplies blood to the liver)

  • Sclerosing cholangitis (bile duct blockage)

  • Steatosis (fatty liver)

  • Viral hepatitis

Other medical causes of enlarged liver and spleen

Enlarged liver and spleen can also be caused by medical conditions including:

  • Amyloidosis (rare immune-related disorder characterized by protein buildup in organs and tissues that can cause serious complications)

  • Congestive heart failure (deterioration of the heart’s ability to pump blood)

  • Cystic fibrosis (congenital respiratory disorder)

  • Glycogen storage disorder or other rare metabolic diseases

  • Sarcoidosis (inflammatory disease most commonly affecting the lungs, skin and eyes)

  • Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)

Serious or life-threatening causes of enlarged liver and spleen

In some cases, enlarged liver and spleen may be a symptom of a serious or life-threatening condition that should be immediately evaluated by a health care provider. These include:

Questions for diagnosing the cause of enlarged liver and spleen

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your enlarged liver and spleen including:

  • Do you have gastrointestinal symptoms such as vomiting or abdominal pain?

  • Does your abdomen feel full or bloated?

  • Have you observed any jaundice?

  • Do you have any chronic medical conditions?

  • What color is your stool?

  • What medications do you take?

What are the potential complications of enlarged liver and spleen?

Because enlarged liver and spleen can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 26
    1. Hepatomegaly. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003275.htm
    2. Splenomegaly. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003276.htm
    3. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
    4. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
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