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The Merck Manual--Second Home Edition logo
 
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Chapter 135. Clinical Manifestations of Liver Disease
Topics: Introduction | Jaundice | Cholestasis | Liver Enlargement | Portal Hypertension | Ascites | Liver Encephalopathy | Liver Failure
 
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Liver Enlargement

An enlarged liver (hepatomegaly) usually indicates liver disease. However, many people with liver disease have a normal-sized or even a shrunken liver. An enlarged liver usually causes no symptoms. However, if the enlargement is extreme, it may cause abdominal discomfort or a feeling of fullness. If the enlargement occurs quickly, the liver may be tender to the touch. When performing a physical examination, a doctor can usually estimate the size of the liver by feeling whether it extends below the level of the ribs.

When feeling an enlarged liver, a doctor also notes its texture. The liver usually feels soft if it is enlarged because of acute hepatitis, fatty infiltration, congestion with blood, or early obstruction of the bile ducts. The liver feels firm and irregular if it is enlarged because of cirrhosis (severe scarring of the liver). Distinct lumps usually suggest cancer. Treatment depends on the underlying cause.

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