Causes and risk factors
Several causes lead to hepatomegaly. These include infections like viral hepatitis, glandular fever, liver abscess, amoebic infection, malaria, hydatid cyst, actinomycosis, and leptospirosis; neoplastic diseases like hepatoma, hepatocellular carcinoma, leukaemia; liver or biliary cirrhosis; metabolic disorders like fatty infiltration , amyloidosis; alcoholism – alcoholic liver disease, other causes like congenital haemolytic anaemia, right ventricular failure, Budd Chiari syndrome, hunter syndrome.
Clinical presentation
Pain, tenderness, enlargement of liver can be found on palpation and percussion in the right hypochondrium. Hepatomegaly can be asymptomatic in most cases such as inactive viral hepatitis. However considerable enlarged liver can lead to symptoms like feeling of fullness and discomfort in abdomen. Hepatomegaly in severe cases is accompanied by symptoms like weakness, fatigue, weight loss, nausea, vomiting, and even jaundice.
Investigation
Medical history by the patient and Clinical examination by the doctor help in diagnosis. Hepatomegaly can be easily diagnosed on physical examination of the abdomen. List of tests are necessary for finding the underlying cause. Liver function test, non invasive procedures like ultrasound examination of abdomen, CT scan, MRI to view liver; invasive procedures like ERCP, MRCP to check the condition of bile duct, liver biopsy to rule out malignancy.
Treatment
Asymptomatic enlargement of liver requires no treatment. Treating the underlying cause is essential in case of severe hepatomegaly. Doctor may advise to choose a healthy diet, reduce alcohol intake, quit smoking, caution in consumption of vitamin supplements or over the counter medications
Other Modes of treatment
The other modes of treatment can also be effective in treating enlarged liver. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating hepatomegaly.
