How to determine the size of the liver
The size of the liver depends on the height, build and age of the person. The doctor can palpate the edge of the liver during examination, but more precisely its size and structure is assessed by ultrasound. The conclusion “diffuse changes in the liver” means a change in the structure of the entire tissue and also requires clarification of the cause. In children, size standards differ from adults, and a slight protrusion of the edge of the liver from under the rib may be normal.
- Examination and palpation of the abdomen
- Ultrasound - size, structure, vessels
- CT or MRI - if focal formations are suspected
- Elastography - assessment of density and fibrosis
Main reasons
The liver becomes enlarged due to the accumulation of fat in the cells, inflammation, stagnation of blood, cell proliferation or deposition of various substances. In adults in Uzbekistan, fatty liver disease and viral hepatitis are the most significant.
- Fatty liver disease (metabolic and alcoholic)
- Viral hepatitis B, C, D
- Congestive liver in heart failure
- Infections: mononucleosis, cytomegalovirus, brucellosis, malaria
- Echinococcosis and other parasitic cysts
- Blood diseases: leukemia, lymphoma
- Metabolic diseases: hemochromatosis, Wilson's disease
- Tumors and metastases
Symptoms
A slight enlargement of the liver is usually not noticeable. Complaints appear with a significant increase or are associated with an underlying disease.
- Heaviness and distension in the right hypochondrium
- Fatigue
- Nausea, loss of appetite
- Jaundice
- Abdominal enlargement
- Symptoms of the underlying disease: shortness of breath, fever, weight loss
Diagnostics
They start with basic tests and markers of viral hepatitis. In fatty liver disease, metabolic risk factors and the degree of fibrosis are assessed. If the cause is not clear, studies are carried out for metabolic diseases, autoimmune diseases and blood diseases, and for focal changes - CT or MRI. People with shortness of breath and swelling have their heart examined.
- General blood test
- ALT, AST, GGT, alkaline phosphatase, bilirubin, albumin
- HBsAg, anti-HCV
- Glucose, lipid profile, ferritin
- Abdominal ultrasound and liver elastography
- Echocardiography if a cardiac cause is suspected
- CT or MRI according to indications
Treatment and recommendations
There is no special “treatment for an enlarged liver” - the cause is treated. For fatty liver disease, weight loss, physical activity, and blood sugar control are key. For hepatitis, antiviral therapy is prescribed, for heart failure - treatment by a cardiologist, for parasitic cysts - surgical or drug treatment. When the cause is eliminated, the size of the liver often returns to normal.
- Give up alcohol
- Gradually lose weight if you are overweight
- Limit sugary drinks and fast food
- Do not take herbs and dietary supplements without consultation
- Get vaccinated against hepatitis B
- Undergo a repeat ultrasound within the time frame specified by the doctor
