Last revised by Rohit Sharma on 29 Mar 2024

Hepatomegaly refers to an increase in size or enlargement of the liver

Hepatomegaly can result from a vast range of pathology including, but not limited to, the following:

Assessment of liver size is commonly made on ultrasound or CT, although gross hepatomegaly may be apparent on abdominal radiograph.

For the adult liver:

  • midclavicular line averages 10-12.5 cm in craniocaudal length 2

    • a liver that is longer than 15.5-16 cm in the midclavicular line (MCL) is considered enlarged

  • average transverse length is 20-23 cm at the level of the upper pole of the right kidney 2

In practice, however, assessment is often subjective.

Features that support hepatomegaly include 1:

  • extension of the right lobe inferior to the lower pole of the right kidney

  • rounding of the hepatic inferior border

Liver volume can be assessed on cross-sectional imaging either using volumetry or by calculating an estimated liver volume from caliper measurements. The following formula was proposed for this purpose 4

Volume = maximum cranio-caudal dimension x maximum latero-lateral dimension x maximum antero-posterior dimension x 0.31

The range of normal liver volume is however dependent on patient population and demographics. Furthermore, liver volume has been shown to demonstrate a diurnal rhythm due to hydration, nutrition, and physical activity, reaching its minimum value between 12:00-14:00 hours 5,6.

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.