Enlarged liver (Riedel lobe)
Nonspecific pain in the right hypochondrium for the past 3 months.
Plain X-Ray abdomen (standing)
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There is an obvious enlargment of the liver. The contour of the liver is clearly visible due to a layer of fat between the abdominal wall and the liver.
Note the prominent shadow of the right kidney. The kidney is in its normal position in the retroperitoneum and is not displaced downward. This suggests that the liver enlargement is from a Riedel lobe, a normal variant of the liver with a large right hepatic lobe. With hepatomegaly, the entire liver would be enlarged and displace intra-abdominal organs.
The cause of hepatomegaly has a vast range of aetiology. Often, the assessment of the liver is made on ultrasound or CT however, in extreme cases such as this, an enlarged liver may be obvious on plain imaging.