Hepatosplenomegaly is a condition that causes swelling and enlargement of the liver and spleen.
Medical conditions related to the liver often begin with the prefix "hepat-" (such as hepatitis) and "splen" refers to the spleen. The term "megaly" indicates that something is abnormally large.
Because both the spleen and liver play essential roles in the body, it is crucial to identify and correct any underlying causes of hepatosplenomegaly.
Several conditions can cause hepatosplenomegaly. Examples include:
- infection, such as hepatitis C, syphilis, or sepsis from a significant bacterial infection
- chronic liver disease with portal hypertension
- cancers, such as amyloidosis or sarcoidosis
- pernicious anemia
- sickle cell anemia
- systemic lupus erythematosus
- trauma, such as a car accident that impacted the spleen and liver
Enlargement of the liver can also cause enlargement of the spleen because the two organs are close to each other.
When the liver increases in size, it places extra pressure on the spleen. This pressure affects blood flow to the spleen, which can cause it to swell and get bigger.
Also, the spleen is responsible for filtering bacteria and viruses. When these cause problems with the liver, they can also affect the spleen.
Doctors may be able to diagnose hepatosplenomegaly more easily if a person has some of the following risk factors:
A person with these risk factors should talk to their doctor about how they can improve their liver health and reduce their risk of developing hepatosplenomegaly.
Hepatosplenomegaly occurs when the liver and spleen are much larger than their typical size. Usually, a person cannot feel the borders of their liver or spleen in their stomach. But if they have hepatosplenomegaly, they can typically feel these organs.
The average adult spleen weighs about 100 to 250 grams (g). From top to bottom, the spleen measures about 11 centimeters (cm) in length.
However, when a person has an enlarged spleen, it can weigh more than 400 g and measure more than 13 cm in length. If a person has extremely pronounced splenomegaly, the spleen can weigh between 500 and 1,000 g.
A healthy liver weighs about 1.4 to 1.5 kg in a male and 1.2 to 1.4 kg in a female. The liver typically measures 16 cm or less in length, but an enlarged liver may be significantly larger than this.
When the liver and spleen are enlarged, they cannot function as well as usual. This can cause symptoms that may include:
- brown urine
- clay-colored bowel movements
- an enlarged or swollen abdomen
- jaundice or yellowing of the eyes and skin
- pain, especially in the upper right portion of the stomach
- unexplained fatigue
The symptoms may range from mild to severe depending on their underlying cause.
Children can experience hepatosplenomegaly, too. Some of the possible causes of hepatosplenomegaly in children include:
- lysosomal storage diseases, which are liver enzyme dysfunctions, such as the inability to process glucocerebroside
- sepsis or severe bacterial infection
A doctor will begin diagnosing hepatosplenomegaly by assessing a person's medical history and current symptoms.
A doctor will do a physical examination, paying specific attention to the abdomen for signs of organ enlargement. They may feel the abdomen for areas of swelling and to see if they can feel the liver and spleen easily.
A doctor will likely order many diagnostic tests to determine the most likely cause of hepatosplenomegaly. These tests include:
- Blood tests: Blood tests for hepatosplenomegaly include a liver function test, a complete blood count, and tests for clotting factors.
- Imaging scans: A computed tomography (CT) scan or ultrasound can help a doctor determine if a tumor or abscess is causing the swelling. Imaging tests can also show how large the liver and spleen are.
- Biopsy: A doctor may surgically remove a small piece of liver tissue to determine if cancerous cells are present.
The treatments for hepatosplenomegaly vary widely depending on the cause of the organ enlargement. Treating the underlying cause will usually help reduce the size of the organs.
Specific medications can be used to treat many of the causes of hepatosplenomegaly, including anemia, HIV, liver disease, and infections. A person may also need to make adjustments to their diet.
If a person has a cancerous tumor that affects the liver or spleen, a doctor may recommend removing the tumor and using chemotherapy or radiation treatments to prevent the cancer from coming back.
In rare cases, a doctor may recommend surgical removal of the spleen and a portion of the liver.
While a person can live without their spleen, they cannot live without their liver. People with severe and life-threatening conditions related to hepatosplenomegaly may require a liver transplant.
Hepatosplenomegaly can be the result of many conditions related to the liver and spleen.
Doctors will evaluate a person's symptoms and use diagnostic testing to determine the best course of treatment. In rare instances, surgical intervention and transplant may be necessary.