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Dr. Andrew Rynne

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What causes liver and spleen enlargement?

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1954 Questions

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Posted on Fri, 17 Mar 2017 in Digestion and Bowels
Question: So for the past year I have been seeing a Gastro over a enlarged liver and mildly enlarged spleen. I had a endoscopy done to check heart burn but there were no varices. Also have had extensive blood work checking for hepititus, anemia, cancer, iron deficiency, Liver protiens, lft's, ect.. so far all my blood work is normal. I had a Catscan a year ago and this is how the found out about it. Fast forward to the beginning of the year. I had a ultra sound done of the abdomen in the beginning of January and it came back Normal except that the spleen was mildly enlarged at 13.6 CM. The liver was 17 CM. The radioligist that read the scan said the liver was normal size and the spleen was mildly enlarged. The Gastro disagreed and said that the liver was enlarged. I had more blood work done at the time and my hemoglobin (17.8) was slightly elevated and my alt (70) & Ast (34) was slightly elevated. I had the blood work drawn at 6 am in the morning and I was dehydrated as well. So he sent me to a hematologist. I went to the hematologist and he inspected everything and said my liver was not enlarged that it is probably normal for me and my spleen was not really that enlarged for him to be concerned. He did more blood work (CBC) and all my blood work came back normal meaning everything to do with my red blood cells including hemaglobin. All Normal. He said he would still send me for a Nuclear liver and spleen scan to make sure. I had that last week and my nuclear scan came back Normal. This report said the spleen is normal size and appears to have normal morpholigy and the liver is normal at 17 CM. Both are functioning fine according to the report. I go back to see him in a few days but I wanted to get your take on this on what he might say and what questions I should ask?
doctor
Answered by Dr. Ramesh Kumar 16 hours later
Brief Answer:
Reports are normal.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query,
Firstly normal size of adult liver is 15 to 16 cm.There can be a variation of 2-4 cm according to sex and size of body.Spleen and LFT are also normal.
You have not mentioned the symptoms for which you have consulted gastroenterologist.Slight variation of liver enzymes and size of organs are insignificant
See we treat patient and symptoms and not figures or number.
In a symptomatic patient even slight variation can be significant however in a asymptomatic patient even mild deranged tests are not significant.
So if possible please mention your history.
Why were these tests done?
What problem were you having?
Are you a smoker or alcoholic?
As off now as per your question,i would say that all reports are normal and i don't think that you need to worry,You can just take some diet tips from your consultant.
In case you have any other query feel free to ask.
Thanks

Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Ramesh Kumar 3 hours later
What originally caused me to go in was I was having mild discomfort on my right lower abdomen. They thought it might be my appendix so thy did a cat scan and thats how they found out about the liver and spleen. I was also 250 pounds at the time and extremely over weight. I have since lost 50 pounds from the stress of this, however I do believe I am getting over the stress of it and starting to believe that everything is good. What really concerned me is that I have been on hydrocodone for 5 years for a back injury but I take it as prescribed because I know the tylenol is bad for you. I do NOT drink at all. I have not drank in over 8 years. I do not smoke or do any type of drugs. I do drink 1 diet pop a day but water the rest of the day. I do have right side upper quadrant pain from time to time but it comes and goes and it extends around to the middle of my back. I am starting to think that the pain in my ribs and upper right stomach are from my back now because I can really feel it when I twist or move in a certain way.. I have since developed stomach issue and the gastro also told me that the lower rib/stomach pain is most likely IBS that is being cause by stressing about it. I have 3 kids and I just need a little mental reassurance.

Thanks
doctor
Answered by Dr. Ramesh Kumar 2 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hello again,
Have gone through your complete history in detail.
Most likely this pain is not related to your liver, spleen or any other abdominal organ. Because if that would have been the case your scans and blood reports should have shown something grossly wrong.

Though not asked yet right upper quadrant pain extending to the middle of your back can be related to your previous back injury.
As far as irritable bowel syndrome is concerned,it usually involves cramping, abdominal pain, bloating, gas, diarrhea and constipation,however you have not mentioned even one of the above mentioned symptoms as your primary complaint;Your chief complaint is pain which Mild in nature;However in case of irritable bowel syndrome most of the times pain is spasmodic in nature.

As your anxiety levels are quiet high,Increased anxiety levels stimulate the autonomous nervous system(In particular vagus nerve) which can cause pain in abdomen.
I would suggest you to take an anti anxiety medication for a few days along with any Over counter probiotic.Take them for few weeks and report after that.
As far as Hydrocodone is concerned its a very safe drug and can be taken for long time without any significant side effect.
In case you need any more information feel free to question.
Thanks.
Above answer was peer-reviewed by : Dr. Prasad
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