We speak of hepatomegaly when the liver increases in volume. A liver that is too large is often silent, does not hurt, but can sometimes be accompanied by certain symptoms suggestive of liver disease (fatty liver, cirrhosis, etc.)
Ensuring more than 300 biological functions, the liver is an essential organ for the functioning of the body. That’s why he is very protected and hidden under the ribs on the right. Its normal size is approximately 13-16cm tall, 28 cm wide and 8 cm thick. But when it increases in volume – called in medical parlance a hepatomegaly – it can be evocative ofliver problem such as steatosis (liver overloaded with fat), hepatitis, NASH or cirrhosis. “In the majority of cases, hepatomegaly is asymptomatic. But sometimes it is accompanied by other symptoms“, indicates Pr Patrick Marcellin, hepatologist. Which ones? pain ? A weight gain ? List of symptoms of an oversized liver.
1. Heaviness in the abdomen
“The liver is a silent and insensitive organ : it does not feel or hurt, which is also problematic because even when the liver is pathological, it does not really cause pain. When it grows, the liver is still not painful, strictly speaking, but may cause a feeling of heaviness, bloating, or localized discomfort in the abdomen, especially when pressed, describes Professor Marcellin. Hepatomegaly is most often linked to a fat overload, benign and reversible (called steatosis), but sometimes hepatomegaly can be pathological and linked to an inflammatory steatosis called NASH, which can lead to a risk of sequelae such as cirrhosis or liver cancer. “Also note thathepatomegaly can reveal hepatitis (inflammation of the liver). hepatomegaly is reversiblein other words if the disease heals, the liver returns to normal size“continues our specialist.
2. Weight loss
An oversized liver is often associated with a loss of appetite and therefore a sudden and unexplained weight loss. Be careful though, weight loss fast and important is not typical of a liver problem and can be a sign of many other diseases: medical advice and additional tests (hepatic test) are necessary.
3. Severe fatigue
When the liver is not doing well, the metabolism is slowed down, which can lead to severe fatigue. “Intense fatigue (asthenia characterized by loss of interest, lack of energy, feeling weak) that persists during the holidays or despite rest may be a sign of a more or less severe liver pathology, like an oversized or engorged liver”, confirms our interlocutor. But beware, fatigue is a symptom common to many pathologies and is not necessarily suggestive of a liver problem. It is advisable to talk to your doctor who can prescribe a liver test if necessary with a dosage of transaminases and gamma GT.
4. Jaundice
Given that in case of hepatic problem, there is fewer and fewer liver cells that are operational, the liver is no longer able to eliminate all the bilirubin (yellow pigment found in bile) which ends up accumulating in the blood. That can lead to jaundice (jaundice in medical parlance). “Jaundice is characterized by yellowish skin, discoloration of the white of the eye in yellow or even dark urinesigns that should lead to consultation”, reminds our interlocutor.
5. Nausea and vomiting
Hepatomegaly can sometimes be accompanied by nausea and vomiting, which again are common symptoms of many diseases. Abdominal ultrasound will show if it’s related to hepatomegaly.
Does an oversized liver hurt?
“No, a big liver doesn’t hurt. At the limit, an inflamed liver (in the case of an inflammatory disease such as hepatitis or NASH) can be sensitive, but one cannot speak of pain. We just feel a little heaviness to the right of the abdomen because the liver is large“, assures Professor Marcellin.
“The liver is relatively discreet on palpation because it is well hidden (the liver is located at the top of the abdomen on the right, just below the ribs and the right lung), and it is supple, soft and elastic“, indicates the hepatologist. Thus, palpation does not always make it possible to determine the size of the liver. The doctor must carry out a “liver percussion” to locate the upper edge of the liver and assess its size (the noise is dull when the organ is dense like the liver, the noise sounds hollow when the organ is filled with air like the lung). But to confirm the diagnosis of hepatomegaly, the key examination is the abdominal ultrasound which will make it possible to accurately measure the size of the liver and give an idea of its density (if it is fibrous, hard, sclerotic… ). Depending on the results, the patient should do a liver test (transaminases and gamma GT) to know the state of his liver.
Thanks to Pr Patrick Marcellin, hepatologist.