Medical expert of the article
New publications
Hepatomegaly in children
Last reviewed: 04.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
If a child's liver is palpated to have a slight or significant increase in size, then this condition is called hepatomegaly. Hepatomegaly in children can be physiological and pathological, moderate and diffuse. What does this mean and when does a child need help, we will discuss in this material.
Causes of hepatomegaly in children
In childhood, approximately from five to seven years, hepatomegaly may be physiological. This symptom goes away on its own, without any treatment. In older children, the physiological nature of hepatomegaly is excluded: here one should look for the causes of this condition.
What are the most common reasons:
- inflammatory processes (various types of hepatitis, infectious diseases, liver intoxication, including drug-induced, liver parasites, bile duct obstruction, liver abscess);
- metabolic disorders (mucopolysaccharide disorders, glycogen metabolism disorders, protein and fat metabolism disorders, as well as copper or porphyrin metabolism disorders);
- disorders of blood and bile outflow (Wilson-Konovalov hepatocerebral dystrophy, liver cirrhosis, venous spasm or thromboembolism, vinyl chloride intoxication, bile duct anomalies, cardiac insufficiency, myelofibrosis);
- liver infiltration (leukemia, hemolytic jaundice, liver metastases, lymphangioma, primary liver tumors, extramedullary type of hematopoietic system, histiocytosis, hemochromatosis);
- damage to liver tissue (biliary cirrhosis, liver cysts, fibrosis, hereditary telangiectasia);
- proliferation of coastal Kupffer cells (in sepsis, excess vitamin A in the body, in granulomatous liver damage).
Hepatomegaly may also be false, for example, due to respiratory diseases (emphysema).
[ 6 ]
Symptoms of Hepatomegaly in Children
Hepatomegaly in children, in addition to an increase in the size of the liver, may be accompanied by the following symptoms:
- yellowing of the skin and mucous membranes;
- the appearance of telangiectasias (spider veins) on the abdomen;
- painful sensation and a feeling of distension in the right hypochondrium;
- loss of appetite;
- the appearance of a bitter taste in the mouth;
- dyspeptic disorders;
- a feeling of apathy, fatigue;
- problems with the blood clotting system.
Sometimes there is an unpleasant smell from the mouth. If the disease lasts for a long time, ascites may occur - accumulation of fluid in the abdominal cavity: in this case, the abdomen increases in size, becomes round and dense.
In a normal state, a child's liver should not protrude beyond the lower right rib. If the organ protrudes more than 2 cm, then this condition is already defined as hepatomegaly. As we have already said above, an enlarged liver in a child of five to seven years old can be physiological: most often, such an enlargement is moderate, that is, the enlargement is observed by 1-2 cm from the edge of the rib.
Moderate hepatomegaly in a child is a medical term used by specialists to distinguish between the description of pathological values and normal values. That is, if they talk about moderate hepatomegaly, they mean that the liver is enlarged, but it is not as pronounced as it could be in the most probable diseases. This condition can be observed after the introduction of vaccines, or due to a violation of the child's diet.
The opposite concept of moderate hepatomegaly is diffuse enlargement of the liver, i.e. obvious. Often, diffuse hepatomegaly is associated with acute inflammatory or dystrophic processes in the organ.
Where does it hurt?
Diagnosis of hepatomegaly in children
Often, a general examination with palpation of the organ in the right hypochondrium may be sufficient to diagnose hepatomegaly in children. Let us recall that hepatomegaly is not a disease – it is only a symptom, a sign of another disease that should be detected and treated.
The doctor must carefully examine the child, pay attention to changes in skin color, the condition of the abdomen. The liver area and abdominal cavity are palpated.
The severity of liver dysfunction can be determined by the results of blood biochemistry, blood clotting tests, and other liver tests.
In some cases, they resort to consultation with specialized specialists: gastroenterologist, hematologist, infectious disease specialist.
The most common and informative diagnostic method is ultrasound examination. This method will help a specialist establish the correct diagnosis even with a moderate increase in the liver in the absence of pronounced additional symptoms. On ultrasound, the doctor can see echo signs of liver tissue structure disorders, the appearance of uncharacteristic formations and elements.
Auxiliary diagnostic methods that allow detection of the underlying disease are:
- immunogram;
- tests for helminths and parasites;
- tumor marker;
- X-ray examination, etc.
What do need to examine?
Treatment of hepatomegaly in children
Treatment of hepatomegaly in children should be comprehensive: it is carried out only under the supervision of a specialist. It is necessary to remember that hepatomegaly is only a symptom of another disease. For this reason, the use of a particular drug can be carried out only after the main pathogenetic cause of liver enlargement is detected. The drugs prescribed by the doctor should affect the initial cause and stop the disease process in the body.
For example, when an infectious or viral disease is detected, antibacterial or antiviral therapy is carried out, and in case of metabolic disorders, restorative or replacement therapy is carried out. In case of cirrhosis, drugs are prescribed that support liver function, replenishing the deficiency of enzyme substances secreted by it.
Hepatoprotective therapy may also be prescribed, which involves creating additional protection for the liver. The following medications are used: Essentiale, Karsil, Heptral, etc.
In addition, the treatment of hepatomegaly requires the appointment of a special diet. The purpose of such a diet is to facilitate the work of the liver, reduce the load on the organ. The emphasis in nutrition is on plant-based and balanced food, with a decrease in the consumption of foods rich in fats and carbohydrates. The diet is especially relevant for hepatomegaly caused by metabolic disorders.
Prevention of hepatomegaly in children
An important element in the prevention of hepatomegaly in children is the child's adherence to a diet, rest regimen, as well as timely treatment of diseases of the body.
It is necessary to avoid excessive physical activity, especially after infectious and inflammatory diseases. Often after hepatitis or cholecystitis, a child may notice increased pain after physical exercise, riding in transport, fast walking or running.
Children should strengthen their immunity, avoid hypothermia and colds. Many infectious diseases (herpes, acute respiratory viral infections, etc.) can cause inflammatory diseases of the biliary system. For the same reason, dental caries should be treated promptly, since bacteria from there can be carried with the blood to almost any organ.
It is also necessary to combat helminthic invasions: parasites from the intestines can enter the gallbladder and bile ducts, which can provoke the development of an inflammatory process and even lead to obstruction of the bile ducts.
The psychological state of the child is of no small importance. Stress, fears, and worries can negatively affect the baby's health and lead to dyskinesia and other liver diseases.
If the doctor has prescribed treatment (for infection, inflammation, etc.), it is important to strictly follow all the doctor's recommendations. Self-medication is not the best option for helping a child.
Do not allow children to overeat: excessive stress on the digestive organs will sooner or later make itself known by the occurrence of some pathology, including liver disease.
Make sure your child is getting proper nutrition, spend more time outdoors with him, ensure he gets enough rest at night, follow hygiene rules, and then your baby will be healthy and active.
Prognosis of hepatomegaly in children
The prognosis of hepatomegaly in children depends on the origin of this symptom and the presence of other signs and complications.
Hepatomegaly associated with an infectious or viral disease is curable. Special treatment, timely initiated and correctly composed, can guarantee a complete cure in more than 80% of cases.
In case of toxic liver damage, the prognosis is somewhat worse, but everything depends on the degree of toxin impact on the liver, as well as on the timeliness of the measures taken. If the pathology has developed into cirrhosis, the prognosis of the disease worsens.
Parents need to remember that timely visits to a specialist and preventive examinations of the child help to detect hepatomegaly already at an early stage. Therefore, do not be afraid of going to the doctor: often this can save the child not only health, but also life.
If hepatomegaly in children is not physiological in nature, then it should not be treated independently: this symptom can be a sign of many diseases that should be identified and treated.