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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Children's Health Enlarged liver or Hepatomegaly in children

Enlarged liver or Hepatomegaly in children

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Liver is the organ situated below the right rib cage. The common cause for liver enlargement in children are viral hepatitis, malaria. The hepatomegaly can be associated with symptoms like jaundice, pain, fever.

The liver is an important organ located in the upper right quadrant of the abdomen. It is responsible for:

  • Filtering the blood.
  • Making bile, a substance that helps digest fat and excrete certain fatty substances
  • Processing and hooking fats to carriers (including cholesterol), and storing sugars, helping the body transport and save energy.
  • Making important proteins, such as most of those involved in blood clotting.
  • Metabolizing many medications, such as barbiturates, sedatives, and amphetamines.
  • Storing iron, copper, vitamins A and D, and several of the B vitamins.
  • Making important proteins like albumin that regulate fluid transport in the blood and kidneys.
  • Helping break down and recycle red blood cells.

Signs and symptoms of enlarged liver:

  • Tenderness. If the liver enlarges quickly, it may be tender to the touch.
  • Pain. A markedly enlarged liver may cause abdominal pain or fullness.
  • Jaundice. If the cause of enlargement affects liver function, it may lead to yellowing of the skin (jaundice).

Common causes of liver enlargement in children are:

  • Viral hepatitis like hepatitis A.
  • Galactosemia, an inherited disease in which the body cannot tolerate certain sugars in milk. These sugars can build up, causing serious damage to the liver and other organs of the body.
  • Alagille's syndrome, a condition in which the bile ducts narrow and deteriorate, especially during the first year of life
  • Alpha 1- antitrypsin deficiency, a genetic liver disease in children that can lead to hepatitis and cirrhosis of the liver
  • Neonatal hepatitis, which is hepatitis that occurs in a newborn during the first few months of life
  • Tyrosinemia, a disorder that causes serious problems with liver metabolism
  • hemorrhagic telangiectasia, a condition in which thin blood vessels allow frequent and easy bleeding of the skin and digestive tract
  • Reye's syndrome, a condition that causes a buildup of fat in the liver. This condition has been linked in some cases to use of aspirin, especially in conjunction with chickenpox, influenza, or other illnesses with fever.
  • Wilson's disease, an inherited condition that causes a buildup of the mineral copper in the liver
  • Thalassemia, a group of hereditary anemia’s, or low red blood cell counts
  • Biliary atresia, a condition in which the bile ducts extending from the liver to the intestine are too small in diameter or are missing
  • Chronic active hepatitis, an inflammation of the liver that causes severe scarring and interference with liver function
  • Cancer of the liver, which may result from cancer in other parts of the body that have spread to the liver.
  • High doses of vitamins like A and D.
  • Certain medications like prolonged use of acetaminophen, certain antibiotics, steroids can lead to enlargement of liver.


  • X-ray examination.
  • Ultrasound scan.
  • CT scan of the abdomen.
  • Liver function tests.
  • Liver biopsy.


Treatment involves treating the cause for enlargement of liver.