Symptom Finder - Hepatomegaly
Hepatomegaly
Differentiating the causes of hepatomegaly begins with the character of the liver edge. A firm nontender liver edge suggests cirrhosis, whereas a
smooth tender liver edge suggests hepatitis or congestive heart failure. A nodular liver surface may indicate metastatic cancer or cirrhosis.
The physician needs to palpate for an enlarged gallbladder. A large nontender gallbladder is often indicative of gallbladder hydrops (due to a
cystic duct stone) or an obstructed common duct by a neoplasm (Courvoisier gallbladder). In the latter instance, there is always jaundice,
whereas in the former instance, there is not. A tender gallbladder suggests cholecystitis and cholelithiasis.
Now, it is necessary to look for systemic signs of cirrhosis (spider angiomata, palmar erythema, gynecomastia, testicular atrophy, ascites,
caput medusae, and hemorrhoids). Most importantly, look for splenomegaly. One should be sure to look for the Kayser–Fleisher ring in the cornea in Wilson disease and the bronze skin in hemochromatosis, not to mention xanthelasma and tendon xanthoma in biliary cirrhosis induced by hyperlipemia.
Differentiating the causes of hepatomegaly begins with the character of the liver edge. A firm nontender liver edge suggests cirrhosis, whereas a
smooth tender liver edge suggests hepatitis or congestive heart failure. A nodular liver surface may indicate metastatic cancer or cirrhosis.
The physician needs to palpate for an enlarged gallbladder. A large nontender gallbladder is often indicative of gallbladder hydrops (due to a
cystic duct stone) or an obstructed common duct by a neoplasm (Courvoisier gallbladder). In the latter instance, there is always jaundice,
whereas in the former instance, there is not. A tender gallbladder suggests cholecystitis and cholelithiasis.
Now, it is necessary to look for systemic signs of cirrhosis (spider angiomata, palmar erythema, gynecomastia, testicular atrophy, ascites,
caput medusae, and hemorrhoids). Most importantly, look for splenomegaly. One should be sure to look for the Kayser–Fleisher ring in the cornea in Wilson disease and the bronze skin in hemochromatosis, not to mention xanthelasma and tendon xanthoma in biliary cirrhosis induced by hyperlipemia.