Causes of Hepatomegaly

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Hepatomegaly describes an enlarged liver. There are many causes of hepatomegaly, and learning some mnemonics might help you to memorise some of them!

Sometimes it is associated with an enlarged spleen – in which case it is referred to as hepatosplenomeagly. See also splenomegaly.

In hepatomegaly, a palpable liver may be felt on abdominal examination.

Massive hepatomegaly = “CRAM”

Cancer – primary and secondary
Right heart failure
Alcoholic liver disease with fatty infiltration
Myeloproliferative diseases (i.e. Chronic myeloid leukaemia, Rubra Vera, Essential Thrombocythaemia)

Moderate hepatomegaly = “FAILL”
all of the above plus

Fatty liver – from diabetes, obesity
Amyloidosis
Iron – haemochromatosis (excess iron)
Lymphoma
Leukaemia – chronic

Mild hepatomegaly
All of the above plus:

Biliary duct obstruction
Infective:
- Hepatitis
- HIV
- EBV
- CMV
Autoimmune

Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio