Citation, DOI, disclosures and article data
At the time the article was created Jeremy Jones had no recorded disclosures.View Jeremy Jones's current disclosures
At the time the article was last revised Bálint Botz had no recorded disclosures.View Bálint Botz's current disclosures
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:
- malignancy/cellular infiltrate
- acquired hepatic conditions
- acquired non-hepatic conditions
- congenital anomalies
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 diameter 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 5:
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 12-14:00 hours 6,7.
- 1. Brant WE, Helms CA. Fundamentals of diagnostic radiology. Lippincott Williams & Wilkins. (2007) ISBN:0781761352. Read it at Google Books - Find it at Amazon
- 2. Kennedy PA, Madding GF. Surgical anatomy of the liver. Surg. Clin. North Am. 1977;57 (2): 233-44. Pubmed citation
- 3. Dähnert W. Radiology Review Manual. (2011) ISBN: 9781609139438
- 4. Wolfgang Dähnert. Radiology Review Manual. (2011) ISBN: 9781609139438
- 5. Muggli D, Müller M, Karlo C, Fornaro J, Marincek B, Frauenfelder T. A Simple Method to Approximate Liver Size on Cross-Sectional Images Using Living Liver Models. Clin Radiol. 2009;64(7):682-9. doi:10.1016/j.crad.2009.02.013 - Pubmed
- 6. Vauthey J. Body Surface Area and Body Weight Predict Total Liver Volume in Western Adults. Liver Transpl. 2002;8(3):233-40. doi:10.1053/jlts.2002.31654 - Pubmed
- 7. Leung N, Farrant P, Peters T. Liver Volume Measurement by Ultrasonography in Normal Subjects and Alcoholic Patients. J Hepatol. 1986;2(2):157-64. doi:10.1016/s0168-8278(86)80074-5