Enlarged Liver (Hepatomegaly)
An enlarged liver, also called hepatomegaly, refers to a liver that is larger than normal when measured on physical exam or imaging. Hepatomegaly is a sign—not a diagnosis—and can be caused by many different conditions, including fatty liver disease, hepatitis, heart failure, metabolic disorders, or certain cancers. Some individuals have no symptoms, while others may experience abdominal fullness, discomfort, or changes in liver function tests.
What is it?
Hepatomegaly occurs when the liver becomes enlarged due to inflammation, fat accumulation, congestion from heart failure, infiltration by abnormal cells, or other underlying processes. Common causes include fatty liver disease (both alcoholic and nonalcoholic), viral hepatitis, congestive heart failure, metabolic storage diseases, and cancers that originate in or spread to the liver.
Imaging helps determine the extent of enlargement and assess the liver’s internal structure for signs of fat buildup, inflammation, masses, or vascular congestion. Radiologists may also evaluate the bile ducts, gallbladder, and surrounding organs to identify related abnormalities.
Important to Know
An enlarged liver can indicate an underlying condition that requires treatment, even if symptoms are mild. Persistent or progressive hepatomegaly may affect liver function or be associated with more serious diseases such as cirrhosis or cancer. Early evaluation can help identify reversible causes, such as fatty liver disease or infections.
Red flag symptoms include jaundice, severe abdominal pain, fever, unexplained weight loss, or swelling of the legs or abdomen—these may indicate worsening liver disease or systemic illness. Follow-up imaging and blood tests may be recommended to track changes over time and guide management.