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$Pretitle{Digestive System}
$Title{What Causes a "Large Liver"?}
$Subject{liver enlargment cirrhosis}
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Copyright (c) 1991   Tribune Media Services, Inc.


What Causes a "Large Liver"?


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QUESTION:  With the needs of a close member of our family in mind, we are
turning to you to ask for explanations about a "large liver".  Would you
please enlighten us about its causes, how it is discovered, and what the
possible cures might be?  Many important decisions will depend upon the
information you can provide us.

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ANSWER:  That is a pretty big task, and well beyond my ability to fulfil
adequately within the restrictions of this column.  However, I can offer you
some basic information and a reliable source for more extensive information
and help.  The first clues to an enlarged liver comes during a physical
examination, when your physician thumps your abdomen (with a technique called
"percussion") and discovers that the lower border of the liver extends below
the edge of the ribs on the right hand side.  Normally the liver is tucked up
under the rib border, lying just under the diaphragm, the large muscle that
pulls and pushes air in and out of the lung.  This finding can be confirmed by
ultrasound tests, or scans using radio-isotopes.  The causes of an enlarged
liver are many indeed, but fall into 5 major classifications; fibrosis/
cirrhosis, inflammations, infiltrative conditions including tumors and cancer,
vascular diseases, and bile duct problems.  While there are many tests that
can be used to help tell one condition from another, the most useful
diagnostic tool is the liver biopsy.  This furnishes the physician with a bit
of liver tissue which can be examined under the microscope.  The two most
common causes of an enlarged liver are cirrhosis and viral hepatitis, each
accounting for about 15 percent of all cases of liver enlargement (or
"hepatomegaly" in medical terminology).  Cirrhosis is frequently associated
with alcoholic liver disease, while viral hepatitis comes in several types,
depending upon the infecting virus.  Type A viral hepatitis is seen mostly in
younger people, and after travel to countries where the disease is wide
spread.  Other types are diagnosed in individuals with needle drug habits,
homosexuals, heterosexuals with multiple partners, after blood transfusion,
and health field workers.  Your best bet to obtain extensive, authoritative
information is to contact the American Liver Foundation, Cedar Grove, NJ
07009, Telephone # 201 857-2626.
ÿ
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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
