Causes of hepatosplenomegaly

Hepatomegaly

  • Malignancy
    • Primary or secondary
  • Hepatic congestion
    • Right heart failure
    • Hepatic vein thrombosis (Budd-Chiari syndrome)
  • Haematological
    • Lymphoma/leukaemia/myeloproliferative
  • Infection
    • Infectious mononucleosis
    • Viral hepatitis
  • Anatomical
    • Riedel’s lobe
  • Other
    • Non-alcoholic fatty liver disease
    • Alcoholic liver disease
    • Sarcoidosis
    • Amyloidosis
    • Infective endocarditis

Splenomegaly

  • Infiltration
    • Leukaemia
    • Lymphoma
    • Myeloproliferative disorders
  • Increased function
    • ↑Extravascular haemolysis (haemoglobinopathy, thalassaemia, spherocytosis)
    • ↑Extramedullary haematopoiesis (myelofibrosis, malignant bone marrow infiltration)
    • ↑Response to infection (HIV/AIDS, glandular fever, infective endocarditis, malaria, autoimmune disorders)
  • Vascular congestion
    • Cirrhosis (causing portal hypertension)
    • Splenic vein obstruction
    • Budd-Chiari syndrome

Hepatosplenomegaly

  • Chronic liver disease with portal hypertension
    • Any cause of chronic liver disease
  • Haematological
    • Leukaemia
    • Lymphoma
    • Myeloproliferative disorders
  • Infections
    • Acute viral hepatitis
    • CMV/EBV
    • Malaria
    • Visceral leishmaniasis
  • Infiltration
    • Amyloidosis
    • Sarcoidosis

Test your knowledge

What would you expect to happen to the size of the liver and spleen in liver cirrhosis?

Oops! This section is restricted to members.

Create an account or log in to continue reading.

What are the causes of massive splenomegaly?

Oops! This section is restricted to members.

Create an account or log in to continue reading.

Which other clinical findings may you expect to find in a patient with hepatosplenomegaly due to a haematological cause?

Oops! This section is restricted to members.

Create an account or log in to continue reading.

Try an OSCE station!

  1. Hepatosplenomegaly abdominal exam
  2. Find loads more stations here
Next
Stomas
Join our email list!
For free OSCE tips and updates